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manbet手机版首先，我将向大家介绍一种测试半圆形运河装置的新方法。manbet手机版正如你所知道的，内耳，不仅是人类的，而且是所有脊椎动物的，由用于听觉的耳蜗和前庭(半圆形通道)组成。manbet手机版前庭半圆形器官的解剖学在瑞典得到了极大的发展古斯塔夫·雷兹乌斯在这个领域的杰出工作我可以在这里向你们展示。manbet手机版你会看到不同种类脊椎动物半圆形管器官的多种发展。manbet手机版多亏了耳科诊所主任g·霍姆格伦教授的好意，我才得以在人体中传递这个器官的解剖准备。manbet手机版直到19世纪，人们对它的功能还完全缺乏了解。manbet手机版第一个在这一领域进行实验研究的是著名的法国生理学家弗洛伦斯。manbet手机版他的研究发表于1825年。manbet手机版弗洛伦斯认为，可以通过破坏半圆形管状物来了解其功能。manbet手机版事实上，这些用鸽子、兔子和其他动物进行的实验产生了相当显著的、持续的和以前未知的干扰。 For instance, if the horizontal semi-circular canal was destroyed in a pigeon, it went on turning horizontally in a circle. If a vertical semi-circular canal was destroyed, the pigeon turned somersaults. Flourens has described the phenomena extremely well. But he did not give an explanation. In particular, he did not have the faintest idea that the animals were suffering from vertigo. For the well known symptoms of vertigo in humans are too different from those in animals for Flourens to have been able to see this connection. Also, the work of a great physiologist in Prague, Purkinje, was unknown to Flourens, although Purkinje was actually, in the same year, investigating the phenomena of vertigo in humans. Purkinje tried out his experiments partly on himself and partly on mentally sick persons, who, at that time, if they became violent were treated by being rotated in a cage until such time as the nausea thus induced made them quiet and manageable again. Purkinje has discovered the involuntary movements of the eye ball during vertigo, the nystagmus of the eyes, about which we shall be speaking a great deal. He has also proved the influence of the head position upon the vertigo symptoms and has shown that the vertigo arises in the head itself. He thought, it is true, that the brain itself was being directly stimulated by the rotation. He knew of Flourens’s work. But strangely enough he too did not realize that Flourens’s animals were suffering from vertigo, nor that in the spot where certain sensations arise there must be a sensory organ present which receives them. Like other research scientists of the 19th century, he had not yet penetrated far enough into epistemology. Even such an obvious idea as to observe an animal with vertigo or to rotate an animal did not occur to him, in spite of the fact that he conducted numerous vertigo experiments with human subjects and made frequent use of animal experiments. You can see from this how easily one can pass by within an inch of the truth.

manbet手机版由于这两位伟大的研究科学家都未能找到谜底，他们同时代的人也未能找到谜底也就不足为奇了。manbet手机版科学在这方面停滞了近40年。manbet手机版直到1861年，一个法国人Ménière才迈出了大胆的一步。

manbet手机版Méinière采取了与他的前任完全不同的路线。manbet手机版他是一名耳科医生，从单纯的临床角度观察了中耳正常的患者经常同时出现眩晕、“Schwerhörigkeit”和耳鸣。manbet手机版现在人们知道听觉的部位在耳蜗。manbet手机版它的破坏或损伤导致耳鸣和“Schwerhörigkeit”。manbet手机版当时人们认为，眩晕症只能由小脑疾病引起。manbet手机版他观察这种病人多年，完全没有发现任何脑部疾病的症状。manbet手机版除了弗洛伦斯的实验，连接耳蜗的半圆形管装置在当时被认为没有任何功能。manbet手机版不知道那里会产生什么疾病。manbet手机版Ménière现在认为眩晕现象是半圆形管装置疾病的症状他现在成功了，弗洛伦斯和浦肯野都失败了，他看透了人类和动物中令人困惑的眩晕表现的多样性，认识到那些被弗洛伦斯做过半圆形管手术的动物都患有眩晕。manbet手机版这是这个人最重要的伟大成就。不幸的是，他在同一年去世，没能活下来享受他的发现带来的名声。 Ménière did not express himself as regards the importance of the semi-circular canal apparatus in normal life. The first to produce a theory on this was the German physiologist, Goltz, in 1870. He thought approximately as follows: if the destruction of the semi-circular canal apparatus gives rise to vertigo and imbalance, then the normal function of this apparatus must be to maintain equilibrium. And he formulated a theory as to how this might be so. I will not go into this theory here, since it was subsequently proved to be incorrect. But from this example you will see the chief importance of a working hypothesis. The interpretation of facts in a certain way stimulates other scientists’ thoughts. The incorrectness and weaknesses of a theory cause other minds to formulate the problems more exactly and in this way scientific progress is made. In actual fact, we observe the spectacle not uncommon in the history of medicine, that only a few years later, in 1874, three men arrived all at the same time at a theory concerning the semi-circular canal apparatus which is even today, broadly speaking, correct. These were a general practitioner who is still alive, Dr. Josef Breuer in Vienna, the Viennese physicist and philosopher, Ernst Mach, who died last year and the American, Crum Brown, in Philadelphia. These three men arrived at the same result in very different ways. Breuer started by repeating Flourens’s experiments with pigeons with improved technique and came directly to the conviction that movement of the fluid in the semi-circular canals, the endolymph, gave rise to the Flourens phenomena. He was, in addition, the first to put animals into rotation and proved thereby that the same phenomena which Flourens had produced by destruction of the semi-circular canals could be equally well produced by rotating the animal when the symptoms would be only transitory and harmless to it, the symptoms being, in fact, the result of rotatory vertigo. He also proved that when the semi-circular canals were destroyed on both sides, rotation no longer produced these symptoms. With this experiment he was the man who purposely took the first steps on the way towards establishing the function of the semi-circular canal apparatus. As a result of his experiments and of much physiological and anatomical deliberation, he came to the conclusion that the semi-circular canal apparatus is a sensory organ for the perception of rotary motion and that the phenomena of rotatory vertigo is the result of abnormally strong stimulation of this sensory organ. Mach set to work in quite a different way. First he established the mathematical equations for rotary movements. Then he made some investigations with human subjects to ascertain whether there was any evidence of a sensory organ capable of perceiving rotary motion. For as a thinker of the philosophical school he could not make the same mistake as Purkinje of imagining that the brain itself perceived directly its pulling as a result of rotation. Gradually, as a result of his deliberations, he was able to prove that all the other senses were incapable of producing the turning sensation. There remained only the semi-circular canal apparatus and he then showed that this, by virtue of its structure, was absolutely suited to the task of perceiving rotary movement. Crum Brown solved the problem in yet another way. He investigated a number of persons with regard to their vertigo symptoms and without much further thought he came directly to the assumption that the semi-circular canal mechanism must be the sensory organ capable of apprehending these quite specific sensations.

manbet手机版他们是半圆形管道装置理论的奠基人。manbet手机版在大量的后续研究科学家中，我只能举出几个最杰出的成就。manbet手机版生理学家中有匈牙利人Högyes;manbet手机版埃瓦尔德是戈尔兹的学生，詹森是临床医生中的一员，他是柏林的耳科医生。manbet手机版Högyes从重新检查和修改弗洛伦斯和布劳耶的实验开始。manbet手机版然后，他给自己设定了一个任务，那就是建立控制眼睛运动的中枢机制的位置，也就是前面提到的眼球震颤，它是由内淋巴的运动引起的。manbet手机版在兔子的问题上，他取得了成功。manbet手机版他能够证明眼球震颤的机制位于听觉神经进入延髓和四边形体之间的大脑部分，大脑其他部分的移除对这种反射的过程没有太大的影响。manbet手机版Hogyes还对动物半圆形管的单侧和双侧破坏后的症状进行了最好的描述，尤其证明了这些症状在受伤后立即最为剧烈，然后逐渐消退，此外，只有一侧破坏所引起的剧烈症状可以通过另一侧的破坏而减少到最低程度。manbet手机版他证明了，事实上，一边的半圆形管影响着另一边的半圆形管，在刺激过程中它们相互平衡。 It was Ewald who conducted the most exact experiments on the semi-circular apparatus in animals. He established an unquestionable connection between specifically directed head and eye movements of the animal with specifically directed movements of the endolymph in the semi-circular canals. It was he, also, who proved the extraordinarily marked and powerful influence of stimulation of the semi-circular canal apparatus upon the entire body musculature, thereby adding to the purely psychological theory of this organ an important new aspect, that of the tonic, reflex influence on the body muscles. Among the clinicians of this epoch, Jansen comes next in importance after Breuer and Mach. He was the first to discover the great significance of nystagmus of the eye as a symptom of disease of the semi-circular canal apparatus. He has given an extremely good description of the course of symptoms in human beings after destruction of the semi-circular canals, although he was, in fact, unaware that he was describing their destruction. He believed rather that he was referring to a special form of disease. Jansen also showed the great frequency with which diseases of the semi-circular canals occur in cases of suppuration of the middle ear and he was the first to remove by operation a suppurating semi-circular canal in human patients. In spite of the pioneer work of all these men, however, the whole field of diseases of the semi-circular canals in humans was veiled in obscurity. It was impossible to understand all the phenomena observed, for there was no real method for testing the function of the apparatus such as had long since been carried out for other sensory organs.

manbet手机版这是可以理解的，因为在其他感觉器官的情况下，功能测试很容易被激发。manbet手机版只需要有系统地安排各种刺激，然后在排除一个成对出现的各处的感觉器官后，再测试另一个。manbet手机版这可以通过眼睛、听觉器官、鼻子、味觉和皮肤敏感性来实现。manbet手机版但是这种单侧测试系统在半圆形管装置中是不可能的。

manbet手机版由布劳耶鼓动的旋转法同时刺激两侧，因此，在几乎总是需要单侧试验的临床使用中，并不令人满意。manbet手机版浦肯野发现的、希锡格等人进一步研究的原电反应法，并没有得出适合临床使用的结果，至今仍是如此。manbet手机版我所发现的热反应法是第一个为这一晦涩的领域带来光明的方法。manbet手机版只有在它被发现之后，才有可能对半圆形管的功能进行系统的检查。manbet手机版现在请允许我告诉你们它的发现历史。

manbet手机版作为一名年轻的耳科医生，我在维也纳波利策教授的诊所工作。manbet手机版在我的病人中，有许多人需要做耳塞。manbet手机版他们中的一些人事后抱怨头晕。manbet手机版很明显，我检查了他们的眼睛，我注意到在做这件事的时候，有一个特定方向的眼球震颤。manbet手机版我记了下来。manbet手机版过了一段时间，当我收集了大约20个这样的观察结果后，我把它们相互比较，惊讶地发现总是相同的音符。manbet手机版这时我意识到，其中一定隐含着某种普遍的原则，但当时我并不理解。manbet手机版偶然的机会帮助了我。manbet手机版我给一位病人打耳针时，他对我说:“医生，我只有在水不够热的时候才会头晕。manbet手机版当我在家里用足够温暖的水洗耳朵时，我从来不会头晕。” I then called the nurse and asked her to get me warmer water for the syringe. She maintained that it was already warm enough. I replied that if the patient found it too cold we should conform to his wish. The next time she brought me very hot water in the bowl. When I syringed the patient’s ear he shouted: “But Doctor, this water is much too hot and now I am giddy again.” I quickly observed his eyes and noticed that the nystagmus was in an exactly opposite direction from the previous one when cold water had been used. It came to me then in a flash that obviously the temperature of the water was responsible for the nystagmus. From this I immediately drew certain conclusions. If the temperature of the water was really responsible, then water at exactly body temperature should cause neither nystagmus nor vertigo. An experiment confirmed this conclusion. Furthermore, I said to myself, if it is the temperature of the water, nystagmus must be caused in normal cases also and not only in cases of suppurating ears. This I was also able to prove.

manbet手机版由于我早期的研究，我毫不怀疑眼球震颤是半圆形管反射作用的结果。manbet手机版因此，进一步的结论是，如果这些物质被摧毁，就不会有反射作用。manbet手机版我现在可以在维也纳耳科诊所的丰富资料中寻找一个合适的病例。manbet手机版不久，我发现了一个中耳严重化脓的病例，即使在持续冷注射器后，也没有眼球震颤反应。manbet手机版我诊断是迷宫(或半圆形管结构)的破坏，手术证明这是正确的。manbet手机版这种反应在内耳疾病诊断中的重要性是显而易见的。manbet手机版但现在必须有一系列的案例来证实它的正确性。manbet手机版这是即将到来的。manbet手机版后来，我开始研究这种测试半圆形管装置的方法的临床价值，用热反应作为对照，同时，现在必须为半圆形管疾病建立一个诊所。manbet手机版在这方面，许多科学家进行了合作，我必须特别提到，除了那些维也纳学派的科学家，斯德哥尔摩耳科学教授贡纳尔·霍尔姆格伦。 I had already recognized the importance of the caloric reaction and yet I could not explain it. In vain I reflected upon it. Then, one day, I had an idea. I remembered the bath water tank and my surprise, as a child, at finding the water immediately above the fire quite cold, whereas higher up, at the top, the tank was so hot that it burned ones finger. The labyrinth reminded me of a bath-water tank, i.e. a container filled with fluid. The temperature of the fluid is, of course, 37°C – body temperature. Suppose I spray one side of the container with cold water? What will happen? The water on this side of the tank will cool, of course, and, therefore, it will attain a higher specific weight than the surrounding water and will sink to the bottom of the container. Other water at body temperature will take its place. If I syringe the ear with hot water, on the other hand, the movement will be exactly the opposite. The movement of the fluid must change, however, when I alter the position of the container, and if I turn the container through 180°, it must change in exactly the opposite direction. Immediately I was able to envisage the kind of test which would serve asmanbet手机版experimentum十字架的manbet手机版对于这一理论。manbet手机版如果在两个头部位置彼此相差180°时，无论是用热液体还是冷液体，都有可能在相反的方向产生眼球震颤，那么这个理论一定是正确的。manbet手机版我去了诊所，安排了实验，事实上，预期的结果非常清楚地展现了出来。manbet手机版两个头部位置相差180°表明眼球震颤的方向完全相反。manbet手机版这个反应的理论现在建立起来了，它与布鲁尔和马赫的理论完全一致。布鲁尔和马赫的理论都认识到，内淋巴的运动，即包含在半圆形管中的液体，是刺激的原因。

manbet手机版我不会在这条思路上继续深入，但是，另一方面，我要提一下我在小脑定位方面的发现。manbet手机版的调查manbet手机版·拉蒙-卡哈尔manbet手机版他的研究表明，前庭神经的每一根纤维，即半圆形管神经，在进入大脑的地方分成若干分支。manbet手机版其中一个分支通向一组细胞，这些细胞与中央眼肌的神经节细胞直接相连。因此，我们可以理解为什么对半圆形管的刺激会引起眼球震颤。manbet手机版然而，有一个分支进入小脑，分成一系列的分支，分别通向小脑的两侧部分，即所谓的小脑半球，和小脑的中心部分，即蚓部。manbet手机版诚然，Ramón y Cajal只对非常小的动物的胚胎进行了这些研究。manbet手机版他的方法不适用于大型动物，尤其不适用于人类。manbet手机版然而，通过类比，我可以得出这样的结论:在人类中，半圆管神经和小脑之间也一定有某种联系。manbet手机版到目前为止，在眩晕引起的症状中，我只提到了转动感和眼球震颤。manbet手机版但你们都知道其他症状，特别是躯干肌肉因平衡紊乱而产生的影响。manbet手机版我不能在这里给你所有的理由，让我得出这样的结论:这种对全身肌肉器官的影响来自通过大脑的半圆形管，但是荷兰解剖学家路易斯·巴尔克1906年出版的关于哺乳动物小脑的书给了我一些非常有价值的指示。manbet手机版在这本书中，Balk大致告诉了我们以下内容。 The efforts of the physiologists have shown us that the cerebellum has something to do with the innervation of the muscular apparatus. In vertebrates we find that the muscular apparatus of the body is very different in different classes of animal. For instance, the giraffe has an enormously long and mobile neck, the mole has a very short and quite immobile neck. Bolk decided, therefore, that obviously the parts of the brain which take care of he neck muscles in these animals must be developed in quite a different way. He examined the cerebellum in both these species and noticed the extremely striking formation of a certain portion of it in the giraffe which was almost completely missing in the mole. From this Balk concluded that this particular portion was concerned with the innervation of the neck muscles. In a similar way coming to conclusions, he arrived at quite definite localizations for all parts of the cerebellum and, what is particularly important for us, that the muscular apparatus of the upper and lower extremities was represented in the side portions of the cerebellum and that of the trunk in the centre portion. Testing the influence of the semi-circular canal apparatus on the trunk muscles is very simple. The patient is asked to stand or walk and disturbances of equilibrium, deviation from a straight line, are noted when the semi-circular canal is stimulated, e.g. by cold water. The effect of stimulation upon the extremities, e.g. the upper extremities, is also very easily demonstrated. The patient is asked to stretch his arm straight out and keep it quite still. Without stimulation of the semi-circular canal mechanism this is done without difficulty. If, however, the ear, let us say the right ear, is syringed with cold water, the patient’s arm will move slowly towards the right without his being aware of it. It can easily be shown that this deviation of movement will also occur with the left upper extremity and also with both legs. This experiment is the most certain way of demonstrating the direct influence on the muscular mechanism. Usually, however, I employ the so-called pointing test. This is as follows: The patient is asked to close his eyes and touch the doctor’s finger with his own index finger, then, still keeping the arm outstretched, to lower it to knee-level, then raise it again and touch the doctor’s finger once more. In a normal state, with very little practice, this can be done without difficulty. After stimulation of the semi-circular canal, i.e. after syringing of the right ear with cold water, a normal subject will not be able to touch the doctor’s finger, but will pass it on the right. The direction of this deviation will differ according to the direction of the nystagmus and is always in an opposite direction to the nystagmus. Should, for instance, nystagmus occur to the right, the finger will pass the target to the left. If nystagmus occurs in a downward direction, then deviation will be upwards. Nystagmus in an upward direction will be associated with deviation below the target. The reactions always affect all four extremities and the whole muscular apparatus.

manbet手机版我现在成功地证明了一个运动方向是在小脑内定位的。manbet手机版因为我发现，在一些病例中，肢体的反应只在一个方向缺失(在患病的小脑半球一侧)，而在另一侧，健康的一侧以及患病一侧肢体的所有其他反应都是正常的。manbet手机版这表明，在小脑半球内，与某一方向的反应有关的神经细胞和神经纤维必须紧密地分布在一起。manbet手机版然而，仔细的调查证明了更多的东西，即在这样的中心内，关节也有局部化。manbet手机版因为我发现在某些情况下，偏斜只发生在肢体的某个关节，而其他所有的反应都是正常的。manbet手机版例如，指测失败只发生在右臂的肩关节向左，而右臂的肘关节、右手腕、右腿的髋关节和左侧的所有关节，在右侧眼球震颤时，都表现出对左侧的正常反应。

manbet手机版调查也证明有许多自发偏离的情况，即。manbet手机版未刺激半圆形管器的病例manbet手机版．manbet手机版让我们假设，例如，在一种情况下，右肩关节向右偏离。manbet手机版如果在这种情况下，我测试的反应是，当右侧有眼球震颤时，右肩关节没有向左偏移，但指向正确，而其他四肢和关节显示典型的向左偏移。manbet手机版通过这种实验的积累，我对小脑的作用方式有了一个绝对明确的概念。manbet手机版我假设小脑中有四个中枢，这些中枢的肌肉器官首先按方向排列，然后在这些中枢中按发音排列——一个中枢负责右侧，一个负责左侧，一个负责向上，一个负责向下。manbet手机版在正常人中，只要半圆管没有受到刺激，这四个中心就会在四肢运动时为肌肉提供一定的张力，称为tonus。manbet手机版每一对中心就像两个缰绳，例如，手臂在它们之间移动。manbet手机版如果两根缰绳都拉得同样紧，手臂就会向所要求的位置移动，没有任何偏差。manbet手机版不过，我可能会把一条缰绳拉得比另一条更用力。manbet手机版如果我刺激半圆管机制就会发生这种情况。 If I produce a nystagmus to the left, this is equivalent to pulling on the right-hand rein and, therefore, the arm deviates to the right. But I can also bring about a deviation of the right arm to the right if I cut the left-hand rein, for then the tension of the right-hand rein which is already present without any stimulation of the semi-circular canal will make itself felt and will pull the right arm spontaneously to the right. If I now attempt to tighten the left-hand rein, this is now, of course, impossible since it has been cut. All I can do is to relax the right-hand rein completely and then the arm will once again point correctly.

manbet手机版现在让我们把这种比较翻译成医学用语。manbet手机版某一中心的疾病，例如右臂tonus向左的中心，会导致右臂向右偏斜，而不刺激半圆形管机制:在指向右的测试中会出现自发偏斜。manbet手机版如果我的右臂出现眼球震颤，也就是说，如果我试图刺激左臂的tonus中枢，我是不成功的，因为这个中枢有病，不能正常工作。manbet手机版我所能做的就是完全抑制右臂的tonus中心向右，从而获得正确的指向。manbet手机版这就是我所讲的小脑生理学和病理学的主要解释。manbet手机版关于它还有许多其他的例子，我在这里没有时间提及。

manbet手机版最后，我必须再提一个实验，这是我第一个用在人类身上的实验，在我看来，它为我们研究大脑的定位提供了重要的结果。manbet手机版这是生理学家W. Trendelenburg首次在类人猿身上进行的实验。manbet手机版Trendelenburg将右脑半球的硬脑膜暴露在经验证明是左手运动中心的那个地方。manbet手机版由于许多研究科学家的工作，大脑中肌肉的位置已经被非常准确地定义了。manbet手机版特伦伯格在这个地方系上了一个可以倒冰水的容器。manbet手机版然后把它放进笼子里，它很快就从昏迷中恢复过来，开始在笼子里走来走去，吃东西，等等。manbet手机版站在笼子外面的特伦伯格突然向胶囊里倒了冰水。manbet手机版猿猴的左臂立刻瘫倒在一边，然而，猿猴却没有注意到。manbet手机版它继续高高兴兴地吃着萝卜，或者在笼子里爬来爬去。但现在，它不用四肢，只用了四肢，因为它的左臂瘫痪了。manbet手机版这种麻痹作用持续的时间和冰水对大脑皮层的冷却作用一样长。 If Trendelenburg exchanged iced water for water at body temperature, the left arm at once came into use again. The animal began to use it for climbing, eating, etc. just as though it had not been paralysed a few seconds earlier. Trendelenburg was able to repeat this experiment over and over again without the slightest damage being shown, and no paralysis remained. This very interesting and important experiment was pointed out to me by Professor Kolmer and I decided at once to use it upon human subjects. Quite by chance, a patient was available with a healed cere-bellar abscess whose life I had saved by operation. Here the dura mater of the cerebellum was exposed immediately underneath the skin and I thought I would try to cool this spot on the skin in order to paralyse temporarily the cerebellum lying beneath it. As a result of the experiment with apes, it was to be assumed that no harm would come to the patient from this procedure. I decided that although the cooling of the skin might not be very pleasant, I could reasonably expose this patient, whose life I had saved, to this small discomfort in order to achieve scientific progress which would benefit the whole of humanity. The experiment was intended to prove two things: (1) the localization in the cere-bellar cortex; (2) the practicability of the cooling method in research into brain function in living human beings. The experiment fulfilled my expectations completely. For the cooling process I used ethyl chloride, the fluid often used in surgery to anaesthetize parts of the skin when small operations are to be carried out here. I froze the skin over the right side of the cerebellum and the effect of this was immediately visible. The right arm deviated immediately to the right and, for the duration of the cooling period, there was no pointing reaction to the left when I produced a nystagmus to the right in the subject. I had, therefore, hit the exact position of the tonus centre for the right-shoulder joint to the left. The momentary paralysis in the patient showed itself by the deviation of the shoulder joint in the right arm to the right during pointing and in the non-appearance of the pointing reaction to the left. As soon as I had proved this and, of course, also the normal pointing action and reactions in all other extremities and joints, I stopped the experiment. Two minutes later the right arm was pointing normally and the reaction to the left appeared. The patient made no complaint at all about the experiment. I repeated it on the same subject approximately twelve times, always with the same result. It was also carried out on a patient in Professor Voss’s Clinic in Frankfurt, where Dr. Hirsch, who was at that time an assistant in the Otological Clinic, used it repeatedly and always with the same success. I also used it successfully on a patient in the Passow Clinic in Berlin in the presence of Professor Beyer and Professor Lewandowsky. During my present stay in Denmark Professor Schmiegelow told me that it had several times been used with success on one of his patients. One can, therefore, say with confidence (1) that localization in this spot is correct, and (2) that the experiment can be used on a large scale without any danger to the patient. During the present war, and afterwards, there will be numerous opportunities of using the experiment, for the instances of head injuries arecountless, in which, after healing of the wounds, the dura mater will be covered with only a thin layer of skin. I am convinced that people with such wounds will be quite ready to co-operate in a safe and painless experiment in the interests of humanity as a whole.