. Eine praktische Abhandlung über die medizinische Diagnose für Studenten und Ärzte . tina. Reagiert die Pupille nicht, befindet sich die Läsion in den Genikulatbodiesoder im Trakt, soweit das Versagen der Pupillenaktivität dazu führt, dass die Läsion sowohl den sensorischen Bewegungsbogen der Pupille als auch die Sehfasern miteinbezogen haben muss. Obwohl das Wernickesign, wenn es anwesend ist, von großem Wert ist, haben jüngste Beobachtungen Avn beschwert, dass seine Abwesenheit nicht schlüssig ist. Läsionen des Optiktraktes können aufgrund von Neoplasmen oder totuberkuläre oder gummatöse Meningitis, oder seltener können sie theresult der zerebralen Erweichung sein
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. A practical treatise on medical diagnosis for students and physicians . tina. If the pupil fails to react, the lesion is in the geniculate bodiesor in the tract, inasmuch as the failure in the pupillary activity indi-cates that the lesion must have involved the sensory motor arc of thepupil as well as the visual fibres. Although when present the Wernickesign is of great value, recent observations have shoAvn that its absence isnot conclusive. Lesions of the optic tract may be due to neoplasms or totubercular or gummatous meningitis, or more rarely they may be theresult of cerebral softening and hemorrhage. As yet clinical evidenceis too meagre to make a diagnosis of lesions of the primary optic ganglia—pulvinar, anterior corpora quadrigemina, and external geniculate bodies—possible, although in lesions of the pulvinar two typical symptomsoccur, viz., hemianopsia and athetosis, and hemianaesthesia may some-times be present. In like manner, while it is generally believed that PLATE T. LEFT VISUAL FIELD. RIGHT VISUAL FIELD.Fixation Point. Fixation Point.. LJntCapsu/e sS^^^^i^, fnl. Capsule ^^^/^ifa/ Gorle:t- R. OccipitC^ PABALYSIS OF THE MOTOR SERVES OF THE EYEBALL. 187 le!^it)ns of the optic radiations cause homonymous hemianopsia, it has notl)cen detinitely proved that these fibres have solely to do with vision. The hemianopsia is usually assumed to depend upon cortical lesions inthe occipital lobe when it is unaccompanied by any of the accessorysvmptoms which have just been detailed. The chief diagnostic symptomof a central lesion, however, is what is designated as negative vision, vision nulle, for in these cases the patient has no subjective sensationsof the defect in his visual field. Cortical hemianopsia may also be incom-plete, one quadrant only of the field being lost. Transitory hemianopsia, or scintillating scotoma, is the occurrence ofsvmmetrical defects in the field of vision which usually conform to thehemianopic type, and in which a play of lights
