THE 
PHYSIOLOGY AM) PATHOLOGY 
OF THE 
CEREBELLUM. 
BY 
WILLIAM A. HAMMOND, M. I)., 
PROFESSOR OF DISEASES OF THE MIND AND NERVOUS SYSTEM, AND OF CLINICAL MEDICINE, 
IN THE BELLEVUE HOSPITAL MEDICAL COLLEGE ; VICE-PRESIDENT OF THE ACADEMY 
OF THE MEDICAL SCIENCES ; OP THE NATIONAL INSTITUTE OF LETTERS, 
ARTS, AND SCIENCES, ETC., ETC., ETC. 
[FROM THE QUARTERLY JOURNAL OF PSYCHOLOGICAL MEDICINE AND \ 
MEDICAL JURISPRUDENCE FOR APRIL, 1860.] 
NEWYORK: 
D. APPLETON & COMPANY, 
90, 92 & 94 GRAOT) STREET. 
1869. 
LW. SCHMIDT, 24 Barclay Street, New York. THE 
PHYSIOLOGY AND PATHOLOGY 
OF THE 
CEEEBELLITM. 
BY 
WILLIAM A. HAMMOND, M. D., 
PEOPESSOE OP DISEASES OP THE HIND AND NEEVOITS SYSTEM, AND OP CLINICAL MEDICINE, 
IN THE BELLEVUE HOSPITAL MEDICAL COLLEGE ; YICE-PBBSIDBNT OP THE ACADEMY 
OP THE MEDICAL SCIENCES ; OP THE NATIONAL INSTITUTE OP LETTEES, 
AETS, AND SCIENCES, ETC., ETC., ETC. 
[FROM THE QUARTERLY JOURNAL OF PSYCHOLOGICAL MEDICINE AND 
MEDICAL JURISPRUDENCE FOR APRIL, 1869.] ' 
NEWYORK: 
D. APPLETON & COMPANY, 
90, 93 & 94 GRAND STREET. 
1869. THE 
PHYSIOLOGY AND PATHOLOGY 
OP THE 
CEREBELLUM. 
(Head before the New York County Medical Society, January 4, 1869.) 
The anatomical relations of tlie cerebellum are so 
distinct as regards size, position, and structure, that 
physiologists, ever since the development of their 
science, have sought with great assiduity to discover 
its functions. First one view and then another has 
been brought forward and urged by argument and by 
appeals to pathology and experiment, but each has in 
its turn lost ground with time, until now it is certain 
that no one theory obtains undivided acceptance, if it 
even commands a majority in its favor. It is, at first 
sight, difficult to account for this skepticism. The or- 
gan in question is one which can readily be submitted 
in living animals to observation and experimental re- 
search ; it is in great part devoid of sensibility, it may 
be pricked and torn and electrized and cauterized 
with impunity, and in some animals may even be al- 4 
THE PHYSIOLOGY ARD PATHOLOGY 
together removed, and life still remain for a long 
time. It might, therefore, he fairly supposed that 
these circumstances would have led to some definite 
results. So far, however, from this being the case, they 
have tended to increase the obscurity of the subject, 
for it is very certain that the functions of an organ, 
which can be mutilated or entirely ablated without the 
production of notable and uniform consequences, can- 
not be very pronounced in their character, even though 
indispensable to the permanent well-being of the ani- 
mal. 
Before the time of Willis the functions of the cere- 
bellum were confounded with those of the cerebrum. 
This author is declared by Vulpian to be the founder 
of cerebellar physiology, but his works contain little 
more than fanciful hypotheses unsustained by facts. 
He regarded the cerebellum as presiding over the in- 
voluntary motions, as being the organ of music, and as 
a generator, by its cortical substance, of the animal 
spirits. 
Foville,1 basing his ideas on the anatomical arrange 
ment and the relations of the cerebellum to the spi- 
nal cord, regards it as the centre of common sensation. 
This view is likewise entertained by Pin el, Grand- 
champ, and Duges. Experimental physiology and 
pathology do not, however, support the hypothesis, 
for it is found that injury, disease, or even complete 
removal of the organ in question, produces no nota- 
ble diminution of sensibility in any part of the 
body. 
Passing over several other theories which have been 
1 Trait 6 Complet de I’Anatomie, de la Physiologie, et de la Pathologie 
du Systeme ISTerveux. Paris, 1844. OF THE CEREBELLUM. 
advanced, relative to the functions of the cerebellum, 
there are two which I propose to consider somewhat 
at length. These are, first, that it is the originator and 
controller of the sexual appetite, and, second, that it 
coordinates the various muscular actions of the body. 
The first theory originated with Gall, and, though 
it met with great opposition when it was promulgated, 
and though it is still vigorously combated, there is a 
good deal of evidence in its favor. Doubtless much 
of the odium in which it is held is due to the fact that 
numerous ignorant pretenders to science have embraced 
it. This, however, should not prevent us investigating 
its pretensions with fairness. 
Numerous cases of injury and disease of the cere- 
bellum attended with derangement of the generative 
function are referred to by Combe 1 and other writers. 
Larrey,2 in an elaborate paper, sustains Gall’s theory, 
and adduces several cases in its support. He alleges 
that acute inflammation of the cerebellum is always ac- 
companied with an exalted state of the animal and or- 
ganic sensibility, without there being any disturbance 
of the intellectual functions. If the injury or disease 
be located in only one of the lobes, the increase of 
sensibility will be found on the same side of the body, 
and will be attended in various gradations by acute 
pain in the occipital region, horripilations, gradual or 
convulsive contractions of the muscles of the face and 
of the upper and lower extremities of the affected side, 
together with painful formication in the fingers and 
toes. Should paralysis supervene, it is always, he as- 
1 A System of Phrenology. Boston, 1834, p. 110. 
2 Observations on Wounds, etc. Translated from the French by E. F. 
Rivinus, M. D. Philadelphia, 1832, p. ] 19. 6 
THE PHYSIOLOGY AND PATHOLOGY 
sorts, confined to the muscles on that side of the body 
corresponding to tbe diseased or injured side of the 
cerebellum. 
In case the patient recover, he will, according to 
Larrey, be subjected to some remarkable infirmities, 
such as a feeling of excessive tenderness in the neck 
and occipital region, and a decided asthenia of the gen- 
ital organs, combined with atrophy of the testicle of 
the side which corresponds to the diseased lobe of the 
cerebellum, or of both, if the whole of this part of the 
encephalon be affected. 
In support of his remarks, Larrey cites the case of 
a young soldier, who, in Egypt, was struck on the back 
of the head by a large splinter of wood. Inflammation, 
supposed to be located in the cerebellum, supervened. 
He eventually so far recovered as to be sent to France. 
Several years elapsed before he again came under Lar- 
rey’s notice. It was then found that his genital or- 
gans were reduced to the size of those of an infant a 
few months old; the power of erection was lost, and 
sexual desire had disappeared. 
In another case, a soldier was struck by the ball of 
a blunderbuss, which, grazing the occipital protuber- 
ance, tore away the extensor muscles of the head in 
its passage from one side to the other. u The patient 
immediately felt a violent pain in the occiput and a 
sense of weight in the whole head, together with numb- 
ness of the lower extremities. His vision and hear- 
ing were so much impaired that he could hardly dis- 
cern any large objects or understand the most piercing 
sounds. His testicles became reduced and wasted 
away, and his penis diminished in the same propor- 
tion, and lost the power of erection.” OF THE CEREBELLUM. 
7 
The third case was that of a man who had received 
a sabre-cut through the occipital bone and dura mater, 
so that the right lobe of the cerebellum could be read- 
ily seen and touched. When the linger was pressed 
upon it, ever so gently, vertigo, syncope, and convul- 
sions were induced, but no pain was experienced. Af- 
ter the first few days the patient lost the faculties of 
vision and hearing on the right or affected side. At 
the same time there was violent pain along the course 
of the spine, and a kind of formication in the testicles, 
the size of which rapidly diminished, so that in less 
than a fortnight they were reduced to the size of small 
beans. The sexual passion became utterly extin- 
guished. 
In the fourth case, the patient was struck on the 
back of the head; among other consequences, the right 
testicle became atrophied, and the power of erection 
lost. 
In the fifth case, in consequence of a blow on the 
head with a piece of wood, an abscess of the right lobe 
of the cerebellum was produced, of which, in about 
three months, the patient died. The 'post-mortem exam- 
ination showed entire disorganization of the right lobe, 
and marked atrophy of the testicle of the affected side. 
In the sixth case, disease of the cerebellum was the 
consequence of erysipelas. The patient lived two 
months subsequently. The post-mortem examination 
revealed the existence of an abscess which had entirely 
taken the place of the left lobe of the cerebellum. The 
scrotum and penis were so much reduced from their 
original size as to be in the second stage of atrophy. 
Two other cases are cited, in which disease of the 
testicles led to supposed atrophy of the cerebellum. THE PHYSIOLOGY AKD PATHOLOGY 
It is worth noticing that in no one of these cases was 
any difficulty in coordinating the muscles perceived. 
Without citing other cases similar to those of Lar- 
rey, and which are familiar to the profession, I desire 
to refer to three remarkable instances, the details of 
which are given by Dr. John D. Fisher,1 of Boston, but 
which appear to have escaped the notice of recent 
writers: 
The first was that of a man aged forty-five, who 
was seen soon after his death, which took place from 
pneumonia. The penis was small; the glans had evi- 
dently seldom, if ever, been uncovered. When ex- 
posed, it was small, pale, and pointed; all the parts of 
the organ resembled those of a boy not yet arrived at 
the age of puberty. The scrotum was soft and flabby, 
and was empty. No testicles were anywhere to be 
found. 
The head was large, measuring 22 inches in cir- 
cumference. The brain was healthy and very large, 
weighing 514 ounces. The relative proportion of the 
cerebellum to the cerebrum was much reduced, for, 
while the latter weighed 47 ounces, the former weighed 
but 4ounces. According to Meckel and others, the 
average weight of the cerebrum and cerebellum, united, 
is 48 ounces—and the weight of the cerebellum to that 
of the cerebrum is as Ito7, or 1 to 8. In this case, 
the cerebellum measured, in its transverse diameter, 4 
inches; in its antero-posterior diameter, 24 inches; 
and in thickness, 14 inch; ordinarily, it measures, 
transversely, 4 inches; antero-posteriorly, 24 inches, 
and perpendicularly, 24 inches. It was, therefore, one- 
1 Contributions illustrative of the Functions of the Cerebellum. Amer- 
ican Journal of the Medical Sciences, February, 1839. OF THE CEREBELLUM. 
9 
third less in size and weight than is ordinarily the case 
in an adult male, and was the exact weight of that of 
a female child six years old, whose body was examined 
at the same time. 
The history of the patient is very interesting. The 
deficiency of testicles was discovered by Dr. Warren. 
His voice was like that of a woman; he had no beard, 
he never exhibited any amorous propensities, or desire 
for female society—as his mother expressed it, he was 
a virgin in feeling and conduct to the day of his death. 
The second case was that of a man aged forty-one, 
who, while a passenger in a railway train, was injured 
by a collision, so that the back part of his neck was 
struck violently against the window-frame of the car. 
The blow was so severe, that he remained for some 
time in a state of insensibility; at first, it was thought 
that his skull was fractured, or his neck dislocated. 
He, however, regained his intelligence, and was con- 
veyed to his residence. On visiting him an hour after 
the accident, Dr. Fisher found him suffering great pain 
in the occipital portion of the head and upper part 
of the neck. He was lying on his back, and was 
unable to rotate his head or move from a horizontal 
position. Every attempt to do so was attended with 
excruciating pain. The muscles of the neck and integ 
uments were swollen, but there were no indications 
of fracture of the cranium, or of fracture or dislocation 
of the vertebrae. 
On the second day after the accident, he complained 
of numbness of the right arm, and of a difficulty in 
passing his urine. Another interesting symptom 
occurred after two weeks when he had left his bed. 
He lost the power of estimating distances; near objects 
appeared to be far off, and to be far below him. The 10 
THE PHYSIOLOGY AXD PATHOLOGY 
street seemed to be of interminable length, and he felt 
as if he were very much taller than the persons with 
whom he conversed. Between the fourth and fifth 
week after his accident, he made the discovery that he 
had lost the desire and physical power for sexual inter- 
course; the ordinary excitations failed altogether in 
causing any amorous feeling, and this condition, he 
was of opinion, had existed since the reception of the 
injury. In the course of four months, the bladder 
recovered its contractile power, but the arm remained 
numb for several months longer. The generative 
function continued dormant for two years, and six 
months later was only partially active. 
The third case is related by Dr. Whittemore. An 
old man, aged seventy-three, had been married forty 
years, and had had eleven children. Soon after mar- 
riage, he began to complain of dizziness and noises in 
the head, to which he was more or less subject till his 
death. Four years before this event, he experienced, 
on rising from bed, for three or four mornings in suc- 
cession, excruciating pain in the head, which was fol- 
lowed by a sensation as if something had given way in 
the left side of the head with an audible crack, which 
led him to inquire if the bystanders had not heard the 
sound, and he was astonished to find they had not. 
After this he became partially deaf in the left ear, and 
the dizziness increased. During these dizzy turns, he 
was obliged to catch hold of the nearest object to keep 
from falling, and at such times every thing seemed to 
be whirling about like wheels, with a motion always 
from right to left. Two years subsequently, he had an 
attack of hemiplegia, and subsequently experienced 
two other attacks, all slight. After the occurrence of 
these, he had a morbid salacity, which continued with OF THE CEREBELLUM. 
11 
little intermission till about three months before his 
death, when it began to subside, so that the desire 
became imperious but once or twice during the night. 
There was, however, no ability to gratify it, owing to 
imperfect erection; and for a year there had been no 
seminal emission. During this last period, he had been 
gradually getting worse, and his mind had lost most 
of its power. A few weeks before his death, he had 
two epileptic attacks. 
On the day after his death his head was examined. 
The dura mater was adherent to the skull, the arach- 
noid was thickened, there was a large quantity of 
serous fluid in the pia mater, and the arteries were 
undergoing ossification; otherwise, the brain was 
healthy, except as regarded the cerebellum. The right 
lobe of this organ was healthy; the left lobe was one- 
fifth smaller, and was found to have lost the greater 
part of its substance owing to the formation of a cavity 
in its tissue. The sides of the cavity were in contact, 
but it had probably contained serum, which had es- 
caped when it was laid open. A coagulum, the size 
of a duck-shot, was found in the left crus, a small por- 
tion of which was destroyed by disease. As remarked 
by the author, we have in this case a somewhat remark- 
able proof of a relation existing between the cerebellum 
and the instinct of reproduction. The revival of the 
instinct and powers of propagation, which had been 
extinguished for years, taking place on the accession 
of a disease of the cerebellum, and continuing active 
till the organ began to lose its firmness of texture, and 
to undergo disorganization, is strong confirmation of 
the evidence furnished by the two preceding cases, that 
this part of the brain is the source and centre of the 
instinct. 12 
THE PHYSIOLOGY Ai\D PATHOLOGY 
The noticeable features of these cases, besides the 
derangement of the sexual appetite, are the entire 
absence, in all, of any symptoms indicating a loss of 
the power of coordination, and the presence of vertigo 
in the third case. (This, it will be recollected, was the 
only one in which either of the crura cerebelli were 
affected.) It will be noted, also, that the hemiplegia 
occurred upon the side of the body opposite to that 
of the disease in the cerebellum. 
Georget,1 whose works upon the brain and nervous 
system are so important, and who has so carefully stud- 
ied the manifestations of the mind in health and dis- 
ease, writes as follows relative to the point under con- 
sideration : 
“ Physicians have observed certain phenomena of 
the generative organs in cerebral affections. Thus, 
erection has been noticed by Bichat as a symptom of 
such disorders. It is not rare in ataxia [Georget does 
not here refer to locomotor ataxia, as now recognized, 
but to an affection described by Pinel, characterized 
by loss of strength and. general enfeeblement of the 
power of sensation and motion]. M. Series has seen 
it in two cases of disease of the cerebellum, of which 
one consisted of an extravasation of blood, and the other 
of an inflammation. It is well known that individuals 
who are hung frequently exhibit this phenomenon, and 
that others have been so depraved as to cause them- 
selves to be suspended by the neck in order to procure 
the power of satisfying their venereal desires. ..... 
“ M. Gall jdaced the seat of physical love in the 
cerebellum. Of all his other phrenological doctrines, 
this is the one in regard to which he has brought for- 
1 De la Physiologie du Systeme Nervous et specialeraent du Ceryeau, 
etc. Paris, 1821, yol. ii., p. 168. OF THE CEEEBELLUM. 
13 
ward tlie greatest amount of proof. The cases of M. 
Serres are here of some weight. M. Larrey cites 
the case of a young soldier who had received a sabre- 
cut on the back of the neck, and who never thereafter 
experienced any venereal excitement. Hippocrates 
assures us that the Scythians rendered themselves 
impotent by dividing the veins behind the ears. This 
tradition, although not founded on fact, indicates, 
nevertheless, that they had recognized a connection 
between the nape of the neck and the genital organs. 
Ferrand, in his treatise De la maladie d?amour, ou 
melancolie erotique, assures us that physicians have 
obtained benefit by the application of leeches to the 
nape of the neck of patients affected with this disease. 
I have myself seen, at the Salpetriere, a woman of ardent 
temperament, whose only mental derangement consisted 
in imperious venereal desires. Before her entrance 
into the hospital she had frequently had sexual inter- 
course ten or fifteen times a day. During her stay, 
she was very often seized with a violent pain in the 
nape of the neck, and at the same time experienced the 
most irresistible sexual desires, which she satisfied by 
masturbation ten or fifteen times a day. These acts 
did not appear to injure her, and soon caused the pain 
in the occiput to disappear.” 
Many other cases, similar to those I have referred 
to, might be readily adduced, were it necessary to do 
so. The fact may be regarded as unquestionable, that 
lesions of the cerebellum do occasionally give rise to 
abnormal sexual manifestations, either of increase or 
diminution. What the physiological and pathological 
importance of this point may be, I propose next to 
inquire. 
Researches into the comparative anatomy of the 14 
THE PHYSIOLOGY AXD PATHOLOGY 
subject go to disprove Gall’s theory. The Amphioxus 
lanceolatus is a vertebrate, the lowest of the fishes, and 
is devoid of a cerebellum. The organ, therefore, is 
not necessary for the performance of the reproductive 
functions. No observations have been made, so far as 
I am aware, relative to the strength of the sexual pas- 
sion in this singular animal. 
Passing upward a little, we come to the lamprey, 
in which, as likewise in the sturgeon, polypterus, and 
lepidosiren, the cerebellum consists of a simple commis- 
sural bridge or fold. In these fish the generative 
organs are extraordinarily large, and in the lamprey 
the sexual instinct is unusually developed, for, during 
the act of copulation, they are stated by Owen I—and1—and 
as I have myself often observed—to entwine or wreathe 
themselves about each other, and thus mutually aid 
in the expulsion of their respective generative prod- 
ucts. So absorbed do they become in their passion, 
that they permit themselves to be taken out of the 
water and replaced without interrupting the act. The 
cerebellum is smaller in the lamprey than in any other 
fish. 
In the shark, on the contrary, it is largest, but it is 
well known that the sexual passion is very feeble in 
this animal. 
Among reptiles, the frog has the smallest cere- 
bellum, and yet this creature is remarkable for its 
strong sexual manifestations, which are so powerful 
that it will continue to embrace the female even after 
its fore-feet have been amputated. In fact, as I have 
ascertained by experiment, the removal of the cerebel- 
lum in this animal does not destroy the sexual pro- 
clivity. 
1 Anatomy of the Vertebrates. Yol. i. Fishes and Reptiles, London, 
1866, p. 287. OF THE CEREBELLUM. 
15 
In birds, tlie cerebellum is large and very much 
more developed than in tlie fislies or reptiles. It is 
marked by circumvolutions or transverse lamellse, which 
vary in number, in different birds, according to tlie 
greater or less size of tlie cerebellum. According to 
Leuret,1 tlie number of these lamellae is never less than 
ten nor more than twenty. 
Now', as regards the generative function, it will 
not, I tliink, be found that there is any direct ac- 
cordance between its power and the number of tlie 
cerebellar lamellae. In tlie chicken they number four- 
teen, and in the goose, sixteen. Yet the former is 
undoubtedly more salacious than the latter. In the 
pigeon and others of the dove family, they number six- 
teen, and in the magpie, twenty; but the former are 
remarkable for their excessive amorous passion, while 
in the latter it is by no means a noticeable character- 
istic. 
Among mammals the cerebellum reaches its highest 
state of development, and in man its utmost degree of 
size and complexity of structure. But we find no cor- 
respondence between this organ and the sexual appe- 
tite such as Gall has attempted to establish. In the 
cat, for instance, the cerebellum is for a mammal slight- 
ly developed, the lateral lobes being very small, but no 
one will contend for the existence of slight sexual pas- 
sion in this animal. In regard to this point, Dr. Car- 
penter says: 
“ A friend who kept some kangaroos in his garden 
informed the author that they were the most salacious 
animals he ever saw—yet their cerebellum is one of 
the smallest to be found in the class (mammalia). 
1 Anatourie Oomparee du Systerne Neryeux. Paris, 1839-1857, t. i., 
p. 281. 16 
THE PHYSIOLOGY AND PATHOLOGY 
Every one knows, again, tire salacity of monkeys, 
there are many which are excited to violent demon- 
strations by the sight even of a human female, and 
there are few which do not practise masturbation 
when kept in solitary confinement; yet in them the 
cerebellum is much smaller than in man, in whom the 
sexual impulse is much less violent.” 
Budge 1 made the discovery that in females irrita- 
tion of the cerebellum caused movements in the cor- 
nua of the uterus and tubes. He also found that a 
like exciting cause produced, in the male, movements 
of the testicles and vasa deferentia. Thus he says : 
“ By a lucky coincidence I made the gratifying ob- 
servation that in an old cat whose testicles lay in the 
abdominal cavity, these organs immediately after death 
moved whenever the cerebellum was irritated with the 
scalpel or with caustic potash. The effect was such 
that, whenever the right lobe of the cerebellum and 
the right half of the vermiform process were irritated, 
movement of the left testis ensued, and the reverse. 
Mere superficial irritation sufficed to produce this re- 
sult. The movement of the testicles soon became so 
palpable in this animal that there could be no doubt 
as to its reality. I hastened to open the entire skull 
and the abdominal cavity, and found the testicles lying 
perfectly still, without any trace of movement. On 
irritating one side of the cerebellum, the testicle of the 
opposite side swelled, quitted its position, and rose up 
so as to form a right angle with the spermatic cord, one 
side of the angle being directed forward. If I desisted 
from the irritation, the testicle returned to its position, 
and the movement was renewed on renewing the irri- 
tTntersuchungen liber das Nervensystem. No. ii., p. 82. OJT THE CEREBELLUM. 
17 
tation. The experiment was repeated during half an 
hour, with unvarying results. After the first irritation, 
not three seconds elapsed before the movement fol- 
lowed ; subsequently, the interval between the irrita- 
tion and the effect was prolonged. The movement 
only lasted a short time, and was diminished more and 
more. Alternately with the cerebellum, I irritated the 
cerebrum, the corpora quadrigemina, the thalami op- 
tici, the corpora striata, but I have never seen the slight- 
est movement result from the irritation of these parts.” 
Valentine confirms Budge’s observations, but Yolk- 
mann has never been able to do so, and Mtiller dis- 
credits them altogether. 
I have endeavored to satisfy myself in regard to 
these jDoints, by repeating Budge’s experiments. In 
one instance, in which a cat was used, decided move- 
ments of the testicles were induced by irritating the 
cerebellum with a scalpel, or with the continuous gal- 
vanic current, applied through two needles. The irri- 
tation of the left lobe produced movements in the right 
testicle, and vice versa. When the current was passed 
through both lobes, both testicles were moved, and the 
penis was also brought into a state of erection. I was 
at first disposed to attach considerable importance to 
these facts, as indicating a very close relation between 
the cerebellum and the generative organs; but, by fur- 
ther observation, I found that irritation of the medul- 
la oblongata and of the cerebrum produced like move- 
ments in both testicles and the penis. I also found that 
irritation of the cerebellum, in either way I have speci- 
fied, caused movements of the intestines, of the abdom- 
inal muscles and of the muscles of the thigh and back. 
My experiments were performed upon three cats just 
killed. lam hence disposed to attach less importance to 18 
THE PHYSIOLOGY AND PATHOLOGY 
Budge’s observations than does Eomberg,1 who quotes 
tbem witb evident approbation. They are, neverthe- 
less, interesting, as showing that, though the connection 
between the cerebellum and the sexual organs is not 
exclusive, there is a relation, in which, however, other 
parts of the body participate, and which, likewise, ex- 
ists with other parts of the brain. 
Coming now to man, we find numerous facts which 
are altogether irreconcilable with Gall’s hypothesis. 
We have seen that there are many cases of injury and 
disease of the cerebellum on record, which tend to 
show that there is some connection between this organ 
and the sexual passion. Observation, however, shows 
us that, as in the lower animals, other parts of the 
cerebro-spinal axis participate in this connection, and 
that the integrity of the cerebellum is not at all essen- 
tial to the existence of strong venereal propensities. 
In the first place, blows upon the back of the neck 
are more apt to injure the spinal cord or medulla ob- 
longata than the cerebellum. The same is true of 
hanging—so that the cases of these kinds, brought for- 
ward in support of Gall’s theory, prove at least as much 
for these organs as they do for the cerebellum. 
Burdach2 collected one hundred and seventy-eight 
cases of injury and disease of the cerebellum, of which 
but ten exhibited any aberration of the sexual func- 
tion. 
In his classical treatise, Ollivier3 (d’Angers) refers 
to fifteen cases (thirteen occurring in his, own expe- 
1A Manual of the Nervous Diseases of Man. Sydenham Society Trans- 
lation, vol. ii., p. 33. 
2 Yom Baue und Leben des Gehirns. Leipsic, 1819-1826; vol. iii., 
p. 423. 
3 Trait 6 des Maladies de la Moelle Bpini&re. 3d edition, Paris, 1837; 
t., i. pp. 316-367. OF THE CEREBELLUM. 
19 
rience) of lesions attended with compression of the 
spinal cord in the cervical region, in eight of which 
there was erection of the penis. In thirteen cases of 
similar lesions in the dorso-lumbar region, erection 
occurred in three. 
Andral1 declares that, in thirty-six cases of disease 
of the cerebellum, permanent erection of the penis was 
present in one only; and, in this, the tubercular mass 
constituting the disease pressed upon the superior part 
of the spinal cord. 
A preparation in the Anatomical Museum, at Bonn, 
is, as Midler2 states, unfavorable to Gall’s opinion. It 
is the cerebellum of a man, in whom half the organ 
was found atrophied. Death had been caused by an 
inflammatory disease. But the sexual passion had 
been rather strong than weak. The man was married, 
and the father of several children. 
But the most remarkable case is one reported by 
M. Combette,3 whose paper is entitled “ Case of a young 
girl who died in her eleventh year, in whom there was 
complete absence of the cerebellum of the posterior 
peduncles, and of the annular protuberance.” I shall 
refer to this case more at length when I come to dis- 
cuss another theory of cerebellar function. At pres- 
ent I will only state that the girl’s name was Alexan- 
drine Labrosse, and that Magendie satisfied himself by 
careful examination that the defect was congenital. She 
entered the Hopital Saint Antoine, where she died. 
M. Combette asserts that he had obtained the certain 
knowledge that this girl practised masturbation. 
1 Clinique Medical, t. v., 2d edition, p. 735. 
2 Elements of Physiology, translated by Baly, vol. i., p. 832; quoted 
from Wagner in Nova Act., Mat. Cur., xiv., p. 111. 
3 Journal de Physiologic Experimentale et Pathologique. Par. F. 
Magendie, t. xi., Paris, 1831, p. 27, et seq. 20 
THE PHYSIOLOGY AND PATHOLOGY 
I have witnessed three cases of injury of tlie spina] 
cord, in winch there were painful and frequent erec- 
tions, and two in which the faculty seemed to he alto- 
gether lost. The usual influence of disease of the cord, 
such as congestion, meningitis, and myelitis, is in the 
early stages to produce frequent erections; later in the 
course of these affections, the symptom disappears. 
In white softening of the cord, the power of erection 
is lost very soon. 
In two cases of general paralysis under my care, in 
which there was no reason to suspect any cerebellar 
lesion, erections, accompanied with strong sexual de- 
sires, occurred among the first symptoms. As the 
disease advanced toward a fatal termination, these 
symptoms became absent. 
Gall asserts that the loss of the testicles causes 
atrophy of the cerebellum. This opinion has not been 
sustained. Leuret1 made many investigations relative 
to the point, and found that in geldings the average 
weight of the cerebellum was 70 grammes; in stallions, 
61, and in mares, 61. The proportionate weight of the 
cerebellum to the cerebrum was in geldings as 1 to 
5.97; in mares, as 1 to 6.59, and in stallions as 1 to 
7.07. So far from the cerebellum decreasing from cas- 
tration, it was found that the cerebrum lost weight from 
this cause. 
Now, if the cerebellum were the sole or even the 
chief originator of the sexual impulse, it ought, judging 
by analogy, to have decreased in size after castration. 
Instances of the dependence of structural integrity 
upon the excitation due to functional activity are so 
frequent, that it is scarcely necessary to cite them. 
The other hypothesis relative to the function of the 
1 Anatomie Compar6e du Syst&me Nerveux, t. i., p. 425, et seq. OF THE CEREBELLUM. 
21 
cerebellum is that which ascribes to it the power of 
coordinating the various muscles of the body so as to 
make them act in harmony, and to obey exactly the 
mandates of the will. 
Although Rolando,1 in 1809, asserted, from numer- 
ous experiments, that the cerebellum is the source and 
origin of all muscular movements, the theory which 
regards it as especially the coordinator originated with 
Flourens in 1822 and 1823, and was published by him 
in papers read in those years before the French Acad- 
emy. My account of it is obtained from the second 
edition of his work on the nervous system,3 published 
in 1842. 
Flourens performed his experiments on birds and 
mammals: among the former class, upon the pigeon, 
turkey, swallow, sparrow, owl, and duck; among the 
latter, on the dormouse, cat, mole, and dog. His 
method was to cut away the organ in successive slices. 
In all his experiments, disorder of movement was pro- 
duced, and this disorder was the more marked, accord- 
ing to the extent of the mutilation—till, at last, tbe 
animal fell, unable to move at all. Flourens states, in 
regard to all of them, that their motions were like those 
produced by drunkenness. He shows, likewise, that 
the cerebellum is insensible; that its injury or removal 
does not interfere with the senses of sight or hearing, 
and that volition and memory are not abolished. A 
blow aimed at an animal thus injured is seen, and the 
effort is made to avoid it, but the power to do so is 
lost. Injury of one side of the cerebellum affects the 
muscles of the opposite side of the body. 
1 Saggio sopra la vera struttura del cervello, etc. Sassari, 1809. 
2 Eecberches Experimentales sur les Propnctcs et les Fonctions du 
Systeme Xervenx. Second edition, Paris, 1842. 22 
THE PHYSIOLOGY AND PATHOLOGY 
Harting1 repeated Flourens’s experiments, and with 
analogons results. He found that the cerebellum was 
devoid of sensibility; that convulsions were not induced 
by its irritation ; that the senses remained in a state of 
integrity, and that no other function appeared to be 
affected except that which relates to order in the move- 
ments. He also noticed that, in those cases where the 
mutilation had been partial only, the power of regu- 
lating the motions was soon regained. 
Bouillaud, Longet, and many others have obtained 
results similar to those of Flourens, and have drawn 
like conclusions from them. 
But, very soon after the publication of Flourens’s 
Memoirs, Magendie went over the ground and de- 
clined to accept his hypothesis. He states2 that hedge- 
hogs and Guinea-pigs, from which he had removed not 
only the cerebellum, but the cerebrum also, rubbed 
their noses with their fore-legs when a flask of vine- 
gar was applied. 
How, one such instance, well authenticated, is suffi- 
cient to overturn Flourens’s hypothesis; for, if one ani- 
mal can coordinate its movements when deprived of 
its cerebellum, then that organ is not absolutely es- 
sential to such coordination. Nevertheless, Flourens’s 
views upon the subject have been largely accepted, and 
probably no other theory of cerebellar function can 
count as many adherents. 
. The arguments which may be brought against it 
are, however, so forcible, and experiments performed 
upon animals of different classes are so strikingly 
against it, that I am forced to regard his doctrine as un- 
1 Experimenta qusedam de affectibus laesionum in partibus encepbalo, 
1826. 
2 Pi'Scis Elementaire de Physiologic. Edition. Paris, 1836, 
t. 5., p. 408, OF THE CEREBELLUM. 
23 
tenable. In addition, tlie records of pathology furnish 
evidence which is absolutely fatal to its pretensions : 
First. The consequences of removal of the cerebel- 
lum, if the animal survives the immediate effects of the 
operation, are not enduring. 
Flourens himself found that there was greater weak- 
ness and hesitation of motion immediately after the 
operation than at a subsequent period. Harting found 
that the full power eventually returned. 
Wagner,1 in 1858, says of animals, from which the 
cerebellum has been removed: 
u The most prominent feature of these phenomena 
is, that they disappear completely, or at least in great 
part, at the end of half an hour, or an hour, if the animal 
is allowed to rest in a comfortable position. When the 
animals survive the operation, and after the wound is 
healed, they continue to walk, though in a somewhat 
uncertain manner, with the feet wide apart, notwith- 
standing that a considerable portion of the cerebellum 
may have been removed. In the generality of cases 
all the symptoms disappear in a few days, and the ani- 
mals recover the faculty of walking, flying, etc., It is, 
therefore, very probable that the phenomena, which 
are manifested immediately after the operation, are 
due to slight injuries or shocks to the deeper parts, such 
as the peduncles of the cerebellum or the medulla ob- 
longata, and that momentary troubles are consequently 
produced in the muscles corresponding to these parts.” 
Dalton’s2 experiments are to the same effect. He 
says; 
1 Kachrichten von der Universitat und der Konigl. Gesellschaft der Wis- 
senscliaften zu Gottingen. Also Journal de la Physiologic de I’lTorame et 
des Animanx, Avril, 1861. 
2 American Journal of the Medical Sciences, January, 1861, p. 83. 
Also Treatise on Human Physiology, 4th edition, 1867, p. 416. 24 
THE PHYSIOLOGY AND PATHOLOGY 
“In the montli of January, 1859, I removed from 
a young but well-grown male pigeon, while under the 
influence of ether, the upper and middle portions of 
the cerebellum, constituting about two-thirds of its 
entire mass. Immediately afterward the pigeon showed 
all the usual effects of this operation in a very marked 
degree. He was incapable of walking, of flying, or even 
of standing still, but struggled and sprawled about 
exactly as other pigeons had done when subjected to a 
similar mutilation. He was used very successfully to 
illustrate the effects of this operation before the medi- 
cal class. 
“This pigeon, however, contrary to my expectation, 
survived, and in the course of a few days it was evi- 
dent he was recovering the control of his limbs. This 
recovery continued to go on at the same time, with the 
general reestablishment of the animal’s health, and at 
the end of five or six days he was again very nearly 
capable of executing all his natural motions—his ap- 
petite was also restored, and he ate and drank freely, 
as before the operation.” 
This pigeon lived for sixteen days, at the end of 
which time he was purposely killed. During his life, 
after the operation, he got along very well, eating, fly- 
ing, walking, and even fighting the other pigeons 
which attempted to take his food. 
Examination showed that about two-thirds of the 
cerebellum had been removed. No attempt at repro- 
duction had been made. 
I have performed several similar experiments to 
the same effect. On one occasion I removed somewhat 
more than two-thirds of the cerebellum from a crow. 
The animal was at first affected in the characteristic 
manner, but gradually it regained its normal condition, OF THE CEREBELLUM. 
25 
and was able to fly, walk, hop, and to alight with 
great exactness. It lived for three months after the 
operation, and was then accidentally killed. 
In another experiment, upon a chicken-cock, I re- 
moved more than half of the cerebellum. For a few 
hours the animal was unable to stand, and kept con- 
tinually moving its head in a gyratory manner, as if 
affected with vertigo. Gradually these phenomena 
disappeared, and in a few days the animal was not to 
be distinguished in his movements from other roosters. 
Several months afterward, he was killed, and, upon 
examination, it was found that the remaining portion of 
the cerebellum down to the peduncles had disappeared. 
It was a noticeable fact that the amorous propensi- 
ties of this bird were not abolished by the operation, 
but that he still continued to perform his marital duties. 
2. The entire removal of the cerebellum from some 
animals does not apparently interfere in the slightest 
degree, even for a moment, luith the regularity and order 
of their movements. 
I have extirpated the cerebellum from the gold-fish 
(Ca/rpo), the sun-fish {Pomotis), the gar (fLepidosteus), 
the trout (fdalmo), the perch (Perea), and other genera 
of fish, without observing the least irregularity of 
movement. The animals swam and balanced them- 
selves in the water, as well without as with a cerebel- 
lum. 
From frogs I have removed it very many times, 
without in the slightest degree, so far as I could per- 
ceive, impairing their powers of motion or of coordina- 
tion. I have also frequently extirpated it from snakes, 
lizards, and turtles, with like results. 
I know it may be alleged that the movements of 
fish and reptiles are very simple, and that therefore 26 
THE PHYSIOLOGY AND PATHOLOGY 
they have no nse for a cerebellum. But this argument 
will not stand. They do have a cerebellum, and, in 
order to perform tlieir various movements, they must 
coordinate. Neither are their movements always so 
very simple. The fish, in balancing itself in the water, 
in avoiding obstacles, and in seizing its food, often ex- 
ercises a great deal of coordinating power. The lizard 
is remarkable for its agility, and for the accuracy of its 
movements, in catching its prey. 
In relation to serpents, their motions are too often 
regarded as consisting of simple lateral vibrations of 
their bodies. But in reality their movements are very 
complex. Owen1 calls attention to this general error, 
and says: 
“ Serpents climb trees by the same mechanism and 
actions as in the first kind of locomotion; the edges of 
the erected scutes laying hold of the bark in succession 
as the body glides spirally up the bough. The tail has 
a prehensile faculty, especially exercised by the great 
constrictors while waiting for their prey 
u Serpents are too commonly looked down upon as 
animals degraded from a higher type, but their whole 
organization, and especially their bony structure, de- 
monstrates that their parts are as exquisitely adapted 
to the form of their whole and to their habits and 
sphere of life as any animal which we call superior to 
them. It is true that the serpent has rio limbs, yet it 
can outclimb the monkey, outswim the fish, outleap 
the jerboa, and, suddenly loosing the close coils of its 
crouching spiral, it can spring into the air and seize the 
bird upon the wing; all these creatures have been 
observed to fall its prey. The serpent has neither 
1 On the Anatomy of the Vertebrates, vol. h, ‘Fishes and Reptile?,’ 
London, 1866, p. 261. OF THE CEREBELLUM. 
hands nor talons, yet it can outwrestle the athlete, 
and crush the tiger in the embrace of its ponderous 
overlapping folds. Instead of licking up its food as it 
glides along, the serpent uplifts its crushed prey and 
presents it grasped in the death-coil as in a hand to its 
slimy, gaping mouth.” 
It is true that frogs in jumping and swimming 
simply ilex and extend their legs, but they must, never- 
theless, ilex and extend them synchronously or dis- 
synchronously according as they desire to move direct- 
ly forward or obliquely, and therefore must coordinate. 
Besides, many of their motions are more complex, such 
as turning themselves on their bellies after being 
placed on their backs, applying their feet to the exact 
seat of an irritation in order to remove it, etc. In the 
tree-frog (Hyla)—from which I have also removed the 
cerebellum without deranging the motional powers of 
the animal—the movements are such as to require still 
more coordinating power. In turtles, the number and 
variety of the movements are extensive, and the ability 
to coordinate correspondingly great. Yet in these 
animals removal of the cerebellum does not appear to 
interfere in the least with the integrity and harmony 
of the muscular actions. 
3. The disorder of movements which results in birds 
and mammals immediately after injury of the cere- 
helium is not due to any loss of coordinating power, hut 
is the result of vertigo. 
The careful examination of the phenomena exhibit- 
ed by a pigeon after ablation of the cerebellum shows 
that it is suffering from a vertigious sensation. Even 
when placed on its breast and allowed to remain at rest, 
there is a trembling and swaying of the body such as 
is produced by alcoholic intoxication. Now, under 28 
THE PHYSIOLOGY AND PATHOLOGY 
sucli circumstances, there are no muscular actions to 
coordinate, and yet the animal makes efforts with its 
wings to preserve its equilibrium. When it attempts 
to walk, it staggers and instantly endeavors to maintain 
its balance. Flourens always speaks of this phenomenon 
as being like that exhibited by a drunken animal— 
but fails to distinguish it from that which would be 
exhibited if the coordinating power were lost. I have 
several times rendered cats, rabbits, and Guinea-pigs 
drunk with whiskey. Their movements are exactly 
like those which result in other animals after injury of 
the cerebellum. My friend Professor A. Flint, Jr., in- 
forms me that he has recently made pigeons drunk, and 
that they act like those which have suffered injury of 
the cerebellum. I have recently performed similar ex- 
periments upon several pigeons. In every case the ap- 
pearance and actions of the animal were not to be 
distinguished from those which occur after removal of 
the cerebellum. There were the same sprawling of the 
wings, the same hesitating and staggering gait, the same 
uncertainty of flight, the same ineffectual efforts to 
avoid a blow, and the same gyratory motion of the 
head and trembling of the body. Ido not believe the 
most experienced experimental physiologist could dis- 
tinguish between two pigeons, one of which was drunk 
and the other suffering from an injury of the cerebel- 
lum. I propose to show the difference between the 
phenomena of vertigo and incoordination under another 
division of the subject. 
4. The 'phenomena of cerebellar disease or injury, 
as exhibited in man, are not such as show any derange- 
ment of the coordinating power. 
Reference has already been made to the case of Al- 
exandrine Labrosse, reported by Combette. It is stated OF THE CEREBELLUM. 
29 
that when she entered the hospital she had but little 
intelligence, appeared indifferent to what was going on 
around her, though she evinced gratitude to those who 
nursed her. When she was spoken to, she answered 
with hesitation and difficulty. Her limbs, although 
weak, were yet strong enough to allow of her walking, 
though she often fell. She possessed all her senses 
She ate moderately, and all her functions of nutrition 
were well performed. 
A year afterward, she had been constantly in bed 
for three months, her face was pale, and her counte- 
nance exhibited an appearance of stupor and of a dete- 
riorated constitution. She remained constantly on her 
back, with her head inclined to the left. She could 
hardly move her limbs, but the sensibility was not di- 
minished. She used her hands readily—and when ad- 
dressed only answered yes or no, but always correctly. 
She died on the 21st of March, 1831, fifteen months 
after her admission to the hospital, and at the age of 
eleven years. 
JJ-pon post-mortem examination the cerebellum was 
found to be entirely absent. In its place there was a 
cellular gelatiniform membrane, semicircular in shape, 
and about eighteen or twenty lines in length. There 
was no pons variolii. 
As M. Combette remarks, Alexandrine Labrosse 
had been able to walk for several years, although al- 
ways in an uncertain manner. Gradually her legs lost 
their strength, and she became paraplegic. Besides, she 
preserved the use of her upper extremities up to the 
last. It is very evident, therefore, that the weakness 
of her legs was due to paralysis—for, had it been the 
result of incoordination, the arms must necessarily have 
participated. In conclusion, M. Combette says, after 30 
THE PHYSIOLOGY AND PATHOLOGY 
giving it as liis opinion tliat tlie case is antagonistic to 
Flourens’s theory: 
“ However that may he, it remains certain that this 
girl lived without a cerebellum, posterior peduncles, or 
cerebral protuberance—and that she probably would 
have continued to live if an abdominal affection had 
not put an end to her days; that she nevertheless en- 
joyed the faculties of sight, touch, and hearing; that, if 
her intelligence was only slightly developed, there was 
not a complete absence of ideas ; and that, though there 
was paraplegia, this had always been incomplete, for the 
sensibility had never been diminished.” 
Magendie, in his comments on the case, after minute- 
ly examining the brain, gives it as his decided opinion 
that the absence of the cerebellum was congenital. 
M. Combette refers to two other cases, in one of 
which there was a large tumor in the left lobe of the 
cerebellum, and in the other an abscess in the same 
position, in neither of which was there any difficulty 
of locomotion. 
M. Lallemand1 cites the case of the vicar of Geze- 
ville, aged forty-six years, who for a year had experi 
enced attacks of vertigo and vomiting, without fever. 
He staggered in walking, and often fell forward. On 
examining his brain after death, the membranes of the 
cerebellum were found to be depressed and shrivelled, 
and to contain only a little brown and fetid lymphatic 
purulent liquid. 
Andral2 states that, of ninety-three cases of cere- 
bellar disease which he has studied, only one appeared 
to support the theory which locates the coordinating 
power in this organ. 
1 Reclicrclics Anatomico-pathologiques sur I’Encephale, etc. Paris, 
1824. 
2 Clinique Medicalc, seconde edition, t, v., p. 735, OF THE CEREBELLUM. 
31 
On the 27th of February, 1836, M. Bouvier1 com- 
municated to the Academic de Medecine the particulars 
of the case of a man who, for a length of time, had been 
subject to a discharge from the ear, with deafness and 
frequent headache. He was suddenly seized with an 
attack of very severe headache, .vomiting, and disorder 
of mind. Three weeks afterward he entered the Hotel 
Dieu. He was then suffering from fixed pain in the 
head, obtuseness of sensibility, somnolency, vomiting, 
etc. The movements of all the limbs were preserved. 
A week subsequently he died. Post-mortem examina- 
tion revealed, as had been foretold, the existence of 
caries of the temporal bone. But there was also found 
an abscess involving the two outer thirds of the left 
hemisphere of the cerebellum ; the walls of this cavity, 
which contained several tablespoonfuls of pus, were 
softened. 
As M. Bouvier remarks, a circumstance of great in- 
terest connected with this case is the entire absence 
during life of any symptoms indicating an augmented 
sensibility, loss of equilibrium, or excitation of the 
genital organs. Passing over a number of other cases 
which could be cited, I desire to relate briefly the par- 
ticulars of two which came under my own notice. 
In 1851, a Mexican shepherd was attacked near 
Cebolleta, in Hew Mexico, by Havajo Indians. He 
managed to escape, but in fleeing from his enemies 
received an arrow-wound in the posterior part of the 
head. He was on horseback, and, though stunned by 
the blow, maintained his seat in the saddle. So firmly 
was the arrow implanted that the shaft became de- 
tached by his efforts to remove it, leaving the head of 
the weapon in the skull. I saw him about two hours 
1 American Medical Intelligencer, April 1839. 32 
THE PHYSIOLOGY AND PATHOLOGY 
subsequently. He was then in full possession of his 
senses and was suffering no pain. There were, however, 
constant vertigo and nausea, together with a sensation, as 
he described it, as if his head were balanced on a very 
delicate point, and the least inclination to one side or 
the other would cause it to fall off. On examining the 
wound, I found the arrow-head still sticking in the bone, 
and I had to use considerable force before I could re- 
move it. It had entered to the extent of an inch and 
a half—a little below and to the left of the occipital 
protuberance—wounding the left lobe of the cerebellum. 
The vertigo continued all that night, but the nausea 
and vomiting stopped in the course of a few hours. 
The next day he attempted to walk, but was 
obliged to desist on account of the vertigo. uHe felt,” 
he said, “ as if he were drunk,” and he staggered just 
iike a drunken man. This feeling of vertigo continued 
for several weeks, lasting all through the period of sup- 
puration. Gradually it disappeared, though, even after 
the lapse of a year, he felt giddy on making any un- 
usual physical exertion. At no time was there any 
difficulty in coordinating the muscles of the upper or 
lower extremities. The latter were simply affected 
through the vertigious sensation. The sensibility was 
unaffected throughout the whole progress of the case. 
The other case was that of a man who, for several 
months, had suffered with vertigo, occasional convul- 
sions, attacks of nausea, and vomiting, and a constant 
and violent pain affecting the back of the head. These 
symptoms had come on subsequently to a severe blow 
which he had received on the back of the head, in con- 
sequence of raising himself too soon while the horse he 
was riding was passing under a low archway. 
When this man attempted to walk he reeled and OF THE CEREBELLUM. 
33 
staggered as if lie were drunk, but bis movements 
were very different from tliose which we now recog- 
nize as characterizing locomotor ataxia. The upper 
extremities and the organs of speech were not affected; 
he had the entire control of his legs when lying down, 
and there was no diminution of sensibility anywhere. 
At last he became paraplegic, and shortly afterward 
died in a convulsion. The post-mortem examination 
showed the existence of an abscess, which had oblit- 
erated nearly the whole of the left lobe of the cere- 
bellum. 
Four cases are now under my charge in which I 
have reason to suspect the existence of cerebellar 
disease. In one of these—that of a gentleman of this 
city—there is intense pain in the occiput, almost con- 
stant vertigo, and slight hemiplegia. When he attempts 
to walk, his gait is staggering, but he lifts his feet in 
perfect coordination, and can stand alone, with his 
eyes shut and his heels close together, tie can place 
either foot, without any difficulty, on any particular 
spot on a chair, and can carry a glass full of water to 
his lips without spilling a drop or looking at it. He 
has no derangement of the coordinating faculty in any 
part of his body, but complains of constant vertigo, 
which is manifestly increased whenever he attempts 
to walk. The sensibility is intact. 
lii another case, that of a gentleman from the West, 
similar symptoms exist. There is intense occipital 
pain, slight hemiplegia, confined to the right leg, ver- 
tigo, and attacks of nansea and vomiting. The giddi- 
ness is so constant that he has it even in his sleep, 
and is often waked by the disagreeable feeling it 
causes. He coordinates perfectly, but cannot walk 
without the support of a cane, owing to the vertigo. 34 
THE PHYSIOLOGY AND PATHOLOGY 
There is no disturbance of sensibility. This gentle- 
man puts on bis stockings and boots without assistance; 
can place tbe big toe of either foot on any point of a 
cbair; can carry a glass full of water to bis moutb; 
can write, and even thread a needle,—and yet in the 
street he is often taken for a drunken man. I need 
not say that the performance of the above-mentioned 
acts would be utterly impossible to a person alfected 
with locomotor ataxia. 
The other two cases have very recently come under 
my notice. One of them is that of a gentleman occu- 
pying a prominent position, who has almost constant 
pain in the back of his head, and vertigo, from which 
he has suffered about two years. In the beginning he 
had, in all probability, an extravasation of blood into 
the left lobe of the cerebellum, for he has a slight 
hemiplegia of the right side, and the pain is located 
on the left side. He informs me that the vertigo is 
often so great that he cannot walk without falling; 
he staggers now with every step, but yet coordinates 
perfectly. In this case there have been no erections 
for a year and a half. 
The other case is that of a married woman, 45 
years of age, sent to me a day or two ago by my 
friend Hr. Woolsey Johnson, and who is afflicted 
with the most extreme and constant desire for sexual 
intercourse. So great is this impulse, that she has 
been in the habit of practising masturbation as many 
as twenty times a day. She has a severe pain in the 
occiput, and almost continued vertigo; there is slight 
paralysis of the left arm. When she walks, her gait 
is staggering, and she says that every thing in the 
room looks as though it were in motion. There are 
no indications of any irritation about the vagina. She OF THE CEREBELLUM. 
35 
informs me that the intensity of the pain and the 
desire for sexual intercourse are in direct relation to 
each other. She coordinates all her muscles perfectly 
well. 
In the New York Medical Journal for June, 1867, 
I detailed, under the head of Convulsive Tremor, the 
particulars of several cases which. I thought consisted 
in functional cerebellar disease. In each of these 
there was pain in the occiput, vertigo, and an uncon- 
trollable tremor, which came on in paroxysms. 
Derangement of locomotion does, therefore, result 
from injury or disease of the cerebellum. Experi- 
mental physiology, as well as pathology, proves this. 
Beyond a doubt, the disorder is, however, clearly due 
to vertigo. There are, moreover, headache, vomitings, 
and eventually, in some cases, hemiplegia, generally 
of the opposite side to that of the cerebellar lesion, a 
fact at variance with Larrey’s assertion. The gait of 
a person thus affected is exactly similar to that of 
a drunken man. As Carre1 says, the movements are 
not abrupt, jerking, and exaggerated, as they are in 
locomotor ataxia. They are more uncertain, and do 
not depend upon any defect of coordination, but upon 
weakness of the voluntary power. 
When either of the peduncles of the cerebellum is 
affected there is an irresistible impulse to go sideways, 
and sometimes gyratory movements are produced. 
The researches of M. Bouillaud,2 of MM. Leven 
and Olivier,3 and of M. Duchenne, are absolutely con- 
clusive on this point. 
1 Xouvelles Recti erches sur t’Ataxie Locomotrice Progressive, etc. 
Paris, 1865, p. 270. 
2 Union Medicate, t. ii., 1859. 
3 Archives Generates, 1803 1863. 36 
THE PHYSIOLOGY AXD PATHOLOGY 
5. In those diseases, of which the chief phenom- 
ena relate to derangement of the coordinating power, 
the lesion is not in the cerebellum, and the symptoms 
are altogether different from those due to cerebellar 
disease or injury. 
The affection known as locomotor ataxia is chiefly 
manifested by incoordination. If the cerebellum were 
the seat of the coordinating power, we should expect to 
find the lesion in this organ. Such, however, is not the 
case. A few cases of so-called locomotor ataxia have 
been reported, in which it was said the cerebellum 
was found diseased; but careful examination shows 
that these were cases of cerebellar disease attended 
with vertigo. In true locomotor ataxia the lesion is 
always found in the posterior columns of the spinal 
cord, or in the posterior roots of the spinal nerves. 
Moreover, in the ataxic form of aphasia, in which 
the patient can write, can move the tongue and lips 
in all possible directions, and yet is unable to so coor- 
dinate the muscles of speech as to enunciate words, 
the lesion is not found in the cerebellum, but in the 
posterior part of the third convolution of the anterior 
lobe of the left cerebral hemisphere. 
Relative to the symptoms which seem to distin- 
guish cerebellar disease from locomotor ataxia, the 
line is well defined. The chief difficulty has been, 
that authors have failed to distinguish between the 
effects of vertigo and the consequences of a loss of the 
coordinating power. Flourens himself, as we have 
seen, made this mistake, and Dr. Todd and others 
have repeated it. Thus Dr. Todd1 says; “ Animals 
deprived of the cerebellum are in a condition very 
similar to that of a drunken man, so far as relates to 
1 Cyclopaedia of Anatomy and Physiology, vol. iii. OF THE CEREBELLUM. 
37 
tlieir power of locomotion. They are unable to pro- 
duce that combination of action in different sets of 
muscles which is necessary to enable them to assume 
or maintain any attitudes.”1 Now, the first sentence 
is true of cerebellar disease, but not of locomotor 
ataxia, of which disease vertigo is not a symptom, 
neither is the gait of an ataxic patient at all like that 
of a drunken man. The second sentence is true of 
persons suffering from locomotor ataxia, but is not 
true of those who have a lesion of the cerebellum, and 
who are able to coordinate perfectly well. 
In lesions of the cerebellum the cutaneous sensi- 
bility remains unimpaired; in locomotor ataxia, on 
the contrary, it is always affected. 
Duchenne, Avho at one time held the opinion that 
locomotor ataxia was a disease, the seat of which was 
in the cerebellum, has lately recanted, and now con- 
tends that there is no relation between them. He 
brings forward several cases which are conclusive as 
to this point. 
I have thus endeavored to clear up several impor- 
tant points relative to the physiology and pathology of 
the cerebellum. In the course of my inquiry I have 
performed a great many experiments upon different 
animals, and have thus arrived at what I think is a 
correct Anew of the physiology of the organ in ques- 
tion. We have seen that it has no special and exclu- 
sive control over the sexual appetite, and no particular 
function to perform in connection with coordination. 
My opinion is, that it has no special or exclusive func- 
tion of any kind, but that it is simply an additional 
generator of nervous power, a ganglion to be added 
1 Diagnostic Differential des Affections Cerebclleuscs et de I’Ataxie 
Locomotrice Progressive.— Gazette Ilebdomadaire, 1860. 38 
THE PHYSIOLOGY AXD PATHOLOGY, ETC. 
to the cerebrum, and performing analogous offices in 
the economy, I advance this theory not without hesi- 
tation ; but, so far as my observation extends, both 
experimental physiology and pathology appear to 
unite in establishing* its correctness. If Ido not now 
O 
adduce the proofs in detail, it is because I am fearful 
of having already wearied you with a subject which, 
though interesting and important, both in its purely 
scientific and practical relations, I am conscious of 
having very imperfectly brought to your attention.