Biographies de neurologues
Nouvelle Iconographie de La Salpêtrière
 L'histoire des neurosciences à La Pitié et à La Salpêtrière J Poirier
The history of neurosciences at La Pitié and La Salpêtrière J Poirier 

mise à jour du
13 avril 2008
vol 21
volume I for 1863
published by John Chirchill & Sons, London.
The Medical Times and Gazette
a journal of medical science
 Ogle JW
Medical and Surgical Practice
28 fébruary 1863
p 213
and pages 659-661


In Dr Brown Séquard's work on the "Physiology of the Nervous system" are some interesting observations on the parts of the nervous system having to do with respiration.
He writes: "In man, haemorrhage in the various parts of the bases of the encephalon, near the median line or upon it, produces trouble in respiration, which is more and more marked the greater the amount of effused blood and the nearer it is to the medulla oblongata. Certainly, in many cases, the trouble of respiration may be partly attributed to pressure on the medulla oblongata, but it is not always so; and, at any rate, in several cases of softening of the pons Varolii, in which it cannot be said that there was a pressure on the oblong medulla, there has been a trouble of respiration. From the examination of a great many cases, I have been led to the conclusion that the whole base of the encephalon is employed in respiration".
Hence we understand why the patients whose cases have been just related (Chas R. and Joseph B.) should suffer from certain defects of respiration referred to the narration of their cases - the gaping in one and the coughing in the other, attended by the involuntary throwing out of the paralysed arm and leg, so that they became quite stiff on that side. The patient Joseph B., said that ever since the attack ha has suffered from what he calls asthma, and before the actual attack he had considerable respiratory trouble.
As is recorded by Dr J.W. Ogle in the ninth volume of the Pathological Society's transactions, in which there were similar symptoms. It was not, however, a case of disease of the pons, but hemiplegia from cancerous disease on the surface of the opposite hemispheres. The case altogether is full of interest, but the following quotation from Dr Ogle's record bears most on our present subject:
"A very remarkable phenomenon during life was the forcible clenching of the paralysed hand during yawning, which would immediately drop after the yawning; as also the involontary muscular motion of the paralysed arm observed when the patient was about to come to the Hospital, and was thereby agitated in the mind. The former of these facts is comparable to the first mentioned by Abercrombie, of a rising up of the paralytic arm in hemiplegia, at each time of yawning. In a letter to the late Mr. Shaw, that physician describes the case of a man who had not the least power of motion of the left side, except underthe following circumstances:
"He was very much affected by yawning, and every time he yawned the paralytic arm raised up, with a firm, staedy motion, until it was at right angles with his body, as he lay in bed. The arm was raised steadily durins inspiration, and, when the expiration began, seemed to drop by its own weight, with considerable force. He continued liable to this affection for a considerable time, and it ceased gradually, and he began to recover the natural motion of the limb".
"This case," Dr Ogle continues, "Bell adduces, as showing how independant the automatic respiratory acts are of the volitional ones, and, as coinciding with the movements of the muscles of the face, shoulders, sterno-mastoid, trapezius, etc., which occur in hemiplegia, through the agency of those nerves which control and combine the muscles in respiration. It is interesting to notice the coincidence of the arm movements in respiration." Dr Ogle adds in a note: "Since the above was written, we have had, in St George's Hospital, a man affected with incomplete hemiplegia, whose paralysed arm shook vehemently on any emotion being experienced, and whose flexed and paraysed fingers were extended involuntary whenever he yawned".
Why a paralysed arm raises during yawning?
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