ON THE ANATOMICAL RELATIONS OF THE NUCliEI OF RECEPTION OF THE COCHLEAR &`* AND VESTIBULAR NERVES. BY FLORENCE R. SABIN. [From t116 Anatomical Laborat& of t?u Jdhns Bopkd Uniwra'ty.] Since the investigations of Babinski,' v. Bechterew,9 Bumm,' Cramer,' Flechsig," Fore],' Kirilzew,' v. Monakow," Onufro- wicz," and Roller," much light has been thrown on the central connections of the cochlear and vestibular nerves by Ram& y Cajal,' Held," v. KGlliker," Martin" and Sala.`" The exact topographical relations of these nuclei have, how- ever, so far been only imperfectly described. The material used in the present study was human tissue and consisted of two superb sets of serial sections, transverse and horizontal, through the medulla of the new-born babe, prepared by Dr. John Hewetson at the Anatomical Laboratory of the University of Leipzig. Through the courtesy of Dr. Hewetson these preparations have been made accessible for study to research-workers in the Anatomical Laboratory of the Johns Hopkins University. A flat reconstruction on mil!imetre paper has been made from the right-hand side of the sections of the transverse series which show the nuclei in question. Reference to the diagram (Fig. 1) will show the following points : At the lower end of the diagram the zero point on the scale represents the superior (anterior) limit of the decnssation of the pyramids, and at the upper end the diagram extends nearly to the lower border of the inferior colliculua of the corpora quadrigemina The lines drawn across the diagram represent approximately the planes of the sections having the corresponding numbers.* The areas. occupied by the nuclei of the nervus hypoglossns and nervus abducens are given to help in orientation. The lines a-a represent the lateral boundary of the fourth ventricle, which has been traced from the point at which the canalis centralis opens out into the floor of the ventricle, through the area of the recessus lateralis and forwards to the aqueductus oerebri. The line 6-b represents the lateral boundary of the corpus restiforme. The entrance of the corpus restiforme into the cerebellum is not shown, but the line runs to its upper *The planes of the sections are in reality slightly different from those represented by the lines on the diagram, which are drawn at right angles to the median line. The sections have been cut slightly obliquely, the right side being struck at a higher plane than the left. The slight discrepancies between the drawings of the sections and the diagrams are thus explaiced. limit. The motor and sensory nuclei of the nervus trigeminus are shown with the exception of the nuclei minores (radicis descendentis). The tractus spinalis nervi trigemini, together with the adjacent substantia gelatinosa, is represented in out- line from its beginning, at the entry zone of the nerve, down- ward as far as the decussation of the pyramids. Its course further spinalwards is not given. The entering root bundle of the nervns trigeminus is also not illustrated, but the lowest section which shows it corresponds to number 45 on the scale, and as the nuclei of the nerve are inferior to the point where it enters, the fibres can be traced farther upwards than the diagram goes. The lines da and dr represent the surface markings on the floor of the fonrth ventricle corresponding to the ala oinere& The complete length of the nucleus alre cinereae is not shown, but it can be traced from the inferior end of the nucleus nervi hypoglossi to the point marked dl on the diagram. The line d,-ds, in which the two snlci meet, corresponds to the portion of the ala cinerea which has been pushed into the depth by the spreading of the nucleus nervi vestibularis medialis dorsal to it over the floor of the ventricle. The line B represents the continuation of the lateral snlcns over the area occupied by the nucleus nervi abducentis. The sulcus is here further lateral, corresponding to the position of the nucleus nervi abducentis, which is further from the median line than the nucleus nervi hypoglossi. N'w vsstibzcli. The area of entrauce of the root bundle of the vestibular nerve is shown in the diagram. The well known fact that the vestibular root bundle is farther forwards (cerebralwards) than the cochlear root bundle is well illns- trated. The reconstruction shows clearly the generally recognized fact that the four principal vestibular nuclei are continuous with one another. (See X, L., 8., and R. d. IZ. ve. in the diagram.) These nuclei can be distinguished in part by position and in part by the character of the cells within them. The relation of the nucleus nervi vestibnlaris medialis tc the nucleus of the descending tract of the vestibular nerve is very striking. Ram6n y Cajal has already pointed out their close connection. The lowest sections in which descending vestibnlar fibres can be distinctly made out show cells between the fibres (sections between 15 and 17 on the scale). These cells higher up make an oval mass which lies JOHNS' BOPKINS BOSPITAL BULLETIN. lateral to the ala cinerea and extends dorsal- and medial to the descending vestibular fibres. As the ala cinema recedes into the depth, and the nucleus nervi hypoglossi disappears, these cells spread to very near the middle line. The large area N, together with the dark area Y, represents the nucleus nervi vestibularis medialis; it can easily be seen that any division between this nucleus and the nucleus of the descending vesti- bular tract, throughout their whole extent, must be merely an arbitrary one. It is extremely di5cult, too, to determine exactly the medial border of the nucleus nervi vestibuli medialis ; it goes over insensibly into the central gray matter surrounding the ventricle. In general the nucleus nervi vestibularis medialis begins from 2& to 3 mm. below the superior end of the nucleus nervi hypoglossi and extends in the floor of the fourth ventricle as far forward as the nucleus nervi abducentis. Its anterior extremity (Yin the diagram) passes forward some distance further lateral to the nucleus of the sixth nerve. *The descending tract of the nervus vesti- buli begins at the entry zone of the vestibular root fibres in the regiou of the nucleus nervi vestibularis superior (Bech- terew), and of the nucleus nervi vestibularis lateralis (Deiters). It is made up of the descending branches of the root fibres and lies dorsal to the tractus spinalis nervi trigemini, at first at a distance. of 1.3 mm. from the floor of the ventricle (Fig. 3). Farther posterior it approaches the floor, and the isolated bundles of fibres of which it is made up occupy a very characteristic oval area, the long diameter of which lies in the dorso-ventral direction (Fig. 2). A reference to the diagram will show that it extends downward from its origin in a straight line as far as the level of the superior (anterior) end of the nucleus nervi hypoglossi. From this point it curvea medialwards, giving place to the nucleus funiculi cuneati. It can be traced downwards to a plane a little superior to the middle of the nucleus nervi hypoglossi. The ascending branches of the vestibular fibres are not represented in the diagram, but they are shown in figs. 3 and 4.* At the extreme superior and lateral angle of the nucleus nervi vestibularis medialis is situated a large group of cells, in part capping the descending tract of the vestibular nerve (Fig. 3, NT.L y). It is oval in shape and is distinctly visible in section just below the floor of the fourth ventricle, As will be seen in the diagram (Fig. 1, Y), it lies adjaoent to the nucleus nervi vestibularis lateralis, to the nucleus nervi vesti- bularis medialis, aud to the nucleus nervi vestibularis spinalis (Radix descendens). This nucleus, however, is worthy of a special description in that it is peculiar: (1) in the size of the cells, they being much larger than those of that part of the nucleus nervi vestibularis medialis marked M in the diagram, but smaller than' those of the nucleus nervi. vesti- bularis lateralis; (2) by the staining capacity of the mass, which on the whole stains in Weigert-Pal preparations of the new-born babe much darker than Deiters' nucleus of the *The so-called cerebellar acoustic nucleus of Ram& y Cajal, the cells of which accompany these fibres, is not represented. ho attempt WSB made to locate in the diagram the gray masses in the roof of the cerebellum, with which the ascending branches of the vestibular nerve undoubtedly come into relation. same section ; (3) by the fact that the cells are closely packed together, which brings it into marked contrast with the more scattered cells of the nucleus nervi vestibularis lateralis ; (4) by its distinct outline in ~~11 stnined preparations, which makes this group of cells easier to differentiate than any of the other vestibular nuclei. A refereuce to Figs. 3 and 4, and to the diagram, Fig. 1, will show the position of the nucleus. This nucleus evidently corresponds to a part of the gaflglicn domate p+,ici of v. Kblli ker (Haupti$ern of Sch walbe.) It is continuous posteriorly with the nucleus of the descending root, and laterally (in its posterior part) with the rest of the nucleus nervi vestibuli medialis. It is not so easy to lecate it definitely in series in which the gray masses are not particu- larly well differentiated, but even in such a series, after having defined it easily in Dr. Hewetson's seotions,`its limits have been recognized