Tractotomy (Sjöqvist), Viewed in the Light of the Pathology of the Medulla Oblongata

Abstract

The remarks I want to make have in particular been called forth by the works of Sjiiqvist, his thesis, and the paper he has read on this occasion on tractotomy in case0 of trigeminal neuralgia. As we have already heard, this tractotomy is a severing of the descending root of the trigeminal nerve, the bulbo-spinal tract. This operation, which Dr. Sjiiqvist has first worked on, interests me intensely. I n the first place it is a very effective therapemtical measure resting on a scientific basis, and the courage shown by Dr. Sjiiqvist and Professor Olivecrona in carrying out the operation is admirable; but the operation is also of interest as an exact experiment concerning lesions of the medulla oblongata.For several years I have been working on the pathology of the medulla oblongata, and of course nr. Sjiiqvist's work has given me much reason for thought. To my opinion some of the problems involved by this work are of general importance also as regards the explanation of atypical trigeminal neuralgias, -use of which they deserve to be discussed. I shall therefore be 80 free a8 to present some of these problems here, even though they are perhaps somewhat outside the scope of to-day's subject. The most remarkable fact is that an operative lesion of the medulla oblongata may cause trigeminal neuralgia to disappear,