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Mechanisms and Machine Science 49
Carlo Ferraresi
Giuseppe Quaglia Editors
Advances in Service
and Industrial
Robotics
Proceedings of the 26th International
Conference on Robotics in Alpe-Adria-Danube
Region, RAAD 2017
Mechanisms and Machine Science
Volume 49
Series editor
Marco Ceccarelli
LARM: Laboratory of Robotics and Mechatronics
DICeM: University of Cassino and South Latium
Via Di Biasio 43, 03043 Cassino (Fr), Italy
e-mail: ceccarelli@unicas.it
More information about this series at http://www.springer.com/series/8779
Carlo Ferraresi Giuseppe Quaglia
•
Editors
Advances in Service
and Industrial Robotics
Proceedings of the 26th International
Conference on Robotics in Alpe-Adria-Danube
Region, RAAD 2017
123
Editors
Carlo Ferraresi Giuseppe Quaglia
Department of Mechanical and Aerospace Department of Mechanical and Aerospace
Engineering Engineering
Politecnico di Torino Politecnico di Torino
Turin Turin
Italy Italy
v
vi Preface
General Chair
Co-chair
vii
viii Organization
Advisory Board
Organizing Committee
General Secretary
ix
x Contents
Vision Systems
Cloud Robot Vision Services Extend High-Performance
Computing Capabilities of Robot Systems . . . . . . . . . . . . . . . . . . . . . . . . 317
Florin Daniel Anton, Theodor Borangiu, Silvia Anton, and Silviu Raileanu
A Robotic 3D Vision System for Automatic Cranial
Prostheses Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 328
Maria Cristina Valigi, Silvia Logozzo, and Gabriele Canella
Automated, Depth Sensor Based Object Detection and Path
Planning for Robot-Aided 3D Scanning . . . . . . . . . . . . . . . . . . . . . . . . . . 336
Jakob Ziegler, Hubert Gattringer, Dominik Kaserer, and Andreas Müller
Collision Avoidance System for Collaborative Robotics . . . . . . . . . . . . . . 344
Stefano Mauro, Leonardo Sabatino Scimmi, and Stefano Pastorelli
Industrial Applications
Airbrush Robotic Painting System: Experimental Validation
of a Colour Spray Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 549
Lorenzo Scalera, Enrico Mazzon, Paolo Gallina,
and Alessandro Gasparetto
Spring Design for Motor Torque Reduction
in Articulated Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 557
Paolo Boscariol, Giovanni Boschetti, Paolo Gallina,
and Chiara Passarini
A Robotic Design for a MIM Based Technology . . . . . . . . . . . . . . . . . . . 565
Hermes Giberti and Luca Sbaglia
Robust One-Shot Robot Programming by Demonstration
Using Entity-Based Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573
Eric M. Orendt, Michael Riedl, and Dominik Henrich
The “Robot Mechanics” Course Experience at Politecnico di Milano . . . . 583
Hermes Giberti and Enrico Fiore
Mechatronic Design and Prototype of a 4-DOFs Hot-Wire CNC
Cutting Machine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 591
Giorgio Figliolini, Pierluigi Rea, and Carlo Cocomello
Robotic Grippers
Development of a NEMS-Technology Based Nano Gripper . . . . . . . . . . . 601
Andrea Veroli, Alessio Buzzin, Rocco Crescenzi, Fabrizio Frezza,
Giampiero de Cesare, Vito D’Andrea, Francesco Mura, Matteo Verotti,
Alden Dochshanov, and Nicola Pio Belfiore
A 3-Finger Robotic Gripper for Grasping Fabrics Based
on Cams-Followers Mechanism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 612
Panagiotis N. Koustoumpardis, Sotiris Smyrnis, and Nikos A. Aspragathos
Experimental Results for QuBu Gripper: A 3-Jaw Electric Gripper. . . . 621
Giuseppe Quaglia and Luca Girolamo Butera
Contents xv
Technological Rehabilitation
P.I.G.R.O.: An Active Exoskeleton for Robotic Neurorehabilitation
Training Driven by an Electro-Pneumatic Control . . . . . . . . . . . . . . . . . . 845
Katiuscia Sacco, Guido Belforte, Gabriella Eula, Terenziano Raparelli,
Silvia Sirolli, Elisabetta Geda, Giuliano Carlo Geminiani, Roberta Virgilio,
and Marina Zettin
Study and Experimentation of Innovative Textile Pneumatic
Muscle Prototypes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 854
Guido Belforte, Gabriella Eula, Alexandre Ivanov, Terenziano Raparelli,
and Silvia Sirolli
Design and Control of Linkage Exoskeletons in Wheelchair . . . . . . . . . . 862
Gao Huang, Marco Ceccarelli, Weimin M. Zhang, Fei Meng, Tao Sun,
and Qiang Huang
An Ethical Reflection on the Application of Cyber Technologies
in the Field of Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 870
Adelaide Conti, Elena Azzalini, Cinzia Amici, Valter Cappellini,
Rodolfo Faglia, and Paola Delbon
Hand Robotic Rehabilitation: From Hospital to Home . . . . . . . . . . . . . . 877
Alberto Borboni, Mauro Serpelloni, Michela Borghetti, Cinzia Amici,
Francesco Aggogeri, Davide Fausti, Massimo Antonini, Maurizio Mor,
Emilio Sardini, and Rodolfo Faglia
Cardiopulmonary Resuscitation Devices: Preliminary Analysis . . . . . . . . 885
Riccardo Adamini, Francesco Aggogeri, Manuela Baronio,
Alberto Borboni, Elisabetta Dal Gal, Nicola Pellegrini, and Carlo Remino
ERRSE: Elbow Robotic Rehabilitation System with an EMG-Based
Force Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 892
Monica Tiboni, Giovanni Legnani, Matteo Lancini, Mauro Serpelloni,
Massimiliano Gobbo, and Davide Fausti
Path’s Slicing Analysis as a Therapist’s Intervention Tool
for Robotic Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 901
Mozafar Saadat, Alireza Rastegarpanah, Che Zulkhairi Abdullah,
Hamid Rakhodaei, Alberto Borboni, and Marco Maddalena
xviii Contents
Biomedical Applications
Human Energy Involved in Manual and Mechanically Facilitate
Harvesting of Saffron Flowers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 931
Andrea Manuello Bertetto, M. Garau, R. Ricciu, Gianmario Satta,
P. Chiappori, and Alberto Concu
Stiffness Characterization of Biological Tissues by Means
of MEMS-Technology Based Micro Grippers Under Position
Control. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 939
Alvise Bagolini, Pierluigi Bellutti, Paolo Di Giamberardino, Imre J. Rudas,
Vito D’Andrea, Matteo Verotti, Alden Dochshanov,
and Nicola P. Belfiore
Bio-Mechatronic Modules for Robotic Massage . . . . . . . . . . . . . . . . . . . . 948
Maksim Arkhipov, Igor Orlov, Vadim Golovin, Liudmila Kocherevskaya,
Vzhesnevsky Evgeny, and Uglev Aleksander
Control of Force Impulse in Human-Machine Impact . . . . . . . . . . . . . . . 956
Carlo De Benedictis, Walter Franco, Daniela Maffiodo, and Carlo Ferraresi
Dionis Surgical Positioner. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 965
Jeremy Olivier, Jerry Bielmann, Mohamed Bouri, and Hannes Bleuler
Method for Measuring the Displacement of Cadaveric Elbow
After the Section of Medial Collateral Ligament Anterior
and Posterior Bundles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 972
Daniele Borzelli, Laura Gastaldi, Cristina Bignardi, Alberto Audenino,
Mara Terzini, Arman Sard, and Stefano Pastorelli
A New Testing Device for the Role of the Trunk in Force Production
and in Balance Control in Disabled Sitting Athletes. . . . . . . . . . . . . . . . . 980
Valeria Rosso, Laura Gastaldi, Walter Rapp, Benedikt Fasel,
Yves Vanlandewijck, Stefan Lindinger, and Vesa Linnamo
Two-Segments Foot Model for Biomechanical Motion Analysis . . . . . . . 988
Elisa Panero, Laura Gastaldi, and Walter Rapp
Validation of Three KUKA Agilus Robots for Application
in Neurosurgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 996
Marko Švaco, Petar Koren, Bojan Jerbić, Josip Vidaković,
Bojan Šekoranja, and Filip Šuligoj
Contents xix
A New Bone Fixation Device for Human Joint Test Rig Machine . . . . . 1007
Luca Luzi, Nicola Sancisi, Michele Conconi, and Vincenzo Parenti Castelli
1 Introduction
The “differential tackling” of the inverse kinematic task of redundant open kine-
matic chains means a generally viable approach (e.g. [1]). Let q ∈ IRn , n ∈ IN
denote the joint coordinates, and let x ∈ IRm , m ∈ IN be the array containing
the Cartesian coordinates of certain points of the robot arm with respect to the
“workshop frame” as well as certain independent components of the orthogo-
nal matrices that prescribe the rotational “poses” of certain links. Normally the
function x(s), s ∈ [sini , sf inal ] ⊂ IR is prescribed for a nominal motion, where
s is a scalar parameter that directly may be the time, or its scaled function. It
corresponds to a one dimensional line in the m dimensional space, sini denotes
c Springer International Publishing AG 2018
C. Ferraresi and G. Quaglia (eds.), Advances in Service and Industrial Robotics,
Mechanisms and Machine Science 49, DOI 10.1007/978-3-319-61276-8 1
4 B. Csanádi et al.
the initial, and sf inal is the final point of this trajectory. If m > n in general
the existence of an exact solution cannot be expected, while the case m < n
corresponds to a redundant arm that may provide ambiguous solutions. The
differential equation Eq. (1)
and the initial condition x(si ) = xini define the differential inverse kinematic
task (normally xini is known), and matrix J is the Jacobian of the problem. The
Null Space of J corresponds to those non-zero arrays IRn a = 0 for which
IRm Ja = 0. Evidently, if dq ds is the solution of Eq. (1), then ds + ak is its
k dqk
introduced for task deformation. In [8] an approach that evaded the minimiza-
tion of any cost function was suggested on the basis of using the Gram-Schmidt
Algorithm (e.g. [9]).
The first version of the here presented approach was published in [10], and
was also applied in the adaptive solution of the inverse kinematic task when the
available kinematic model is only a good approximation of the robot arm in use
[11]. In Sect. 2 at first this basic idea is outlined, then the possible modifications
are introduced.
dF ∂f
qi+1 − q ≈ I + A (qi − q ) = [I + AM ](qi − q ), (3)
dξ ξ ∂q q
of convergence generally are not valid. Further problem arose for the redundant
robots since their Jacobians were not quadratic matrices. To simultaneously
def
eliminate these problems it was suggested to solve the “modified problem” x̃ =
J (q)x = J (q)f (q) by iteration. In it the number of the components in x̃ is
T T
Since in the inverse kinematic task the “home position” of the robot is always
known, it is reasonable to assume that in the initial point si we are just in the
fixed point, and if we apply only small steps to calculate the next point, we
can work with an exactly positive semidefinite matrix. Because the Jacobian
must be calculated but its inverse is not computed, the mehod was referred to
as a “quasi-differential approach”. Its main advantages, that were illustrated via
numerical computations in [8] are as follows:
1. According to the geometric interpretation of the null space of J Eq. (4) means
that the array J T Δf is exempt from the elements of this null space, therefore
it may have solution even when the equation Δf = JΔq cannot be solved.
That means that the iteration will not fail for unreachable points.
2. If Δqk is in the null space of J, Δqk+1 = J T JΔqk = 0, therefore the appro-
priate components of q will stagnate, while for the other components the
iterative sequence will converge to the best approximation of the solution, as
it happened in the case of the application of the Gram-Schmidt Algorithm
in [8].
Further formal possibilities that are investigated in this paper at first are related
to the idea of seeking null-space-free modification of the generalized coordinates
in the form of Δq = J T Δw
Since in Eq. (5) the unreachable components are not removed from Δf , the Tay-
lor series-based approximation cannot be used for such points. Otherwise, the
matrix J(q)J T (q) is again positive semidefinite, therefore for the reachable points
convergence can be expected. To cure this problem we can take it into consider-
T T
ation that J(q)J T (q) is symmetric. If S = S T , then S 2 = (SS) = S T S T =
S , that is the square of a symmetric matrix is always symmetric. Furthermore, a
2
that may eliminate the problem of the unreachable points, assuming that the
solution can be generated without the use of the elements of the null space of J.
As it can be seen from the simulation results above, this assumption cannot be
generally held.
3 Computational Results
In the computations a 8 DoF robot arm similar, but more detailed to that consid-
ered in [8] was used. (To spare room its details are not given in this paper.) In the
present investigations a nominal trajectory was generated by rotating the axes
of this arm while the lengths of the arm segments were either constant or peri-
odically were shrunk and re-dilated to their original length depending on time.
For the measurement of the pose (orientation) error the difference
of the nom-
N 2
def i,j (Oij −Oij )
inal and the actual orthogonal matrices were used as oerr = √
3
.
This measure is reasonable since an orthogonal matrix of size 3 × 3 consists
of three pairwisely orthogonal unit vectors therefore the sum of squares of its
matrix elements must be always 3. The parameters of the simulation are given
in Table 1.
Figure 1 shows the numerical results for the “original”, i.e. the J T J-based
solution when the lengths of the trajectory generating segments were constant
and identical to that of the tracking arm. The suggested method yielded good tra-
jectory and orientation tracking. It is evident that the “generating joint angles”
differ from the realized ones that reveals the use of the elements of the null
space of J. In Fig. 3 the non-trivial results are displayed when the trajectory to
be tracked was generated by longer links than that of the tracking arm. In this
case precise trajectory tracking is impossible, but the algorithm provided us with
some useful “deformed solution”. Figure 4 represents the opposite case when the
trajectory was generated a shrunk robot arm, therefore it was traceable by the
original, longer arm.
Parameter Value
The adaptive function F (ξ) = atanh (tanh(ξ + D)/2)
Steps in the internal cycles 10
Adaptive parameter D 0.3
Adaptive parameter A −0.01 rad−1
Adaptive parameter (dependent value) ξ 0.2594563670316664
The number of discrete points in the trajectory 10000
Time resolution (s ≡ t) δt 0.001 [s]
8 B. Csanádi et al.
Fig. 1. The original [J T J-based] solution for links of constant lengths in the trajec-
tory generation. (The minimal egenvalues numerically correspond to the theoretically
expected value 0.)
Fig. 2. The alternative [f J T w -based] solution for links of constant lengths in the
trajectory generation.
The counterpart of Fig. 1 is Fig. 2 that displays the behavior of the f J T w -
based solution. As far as the eigenvalues of JJ T are concerned, they could guar-
antee convergence but the solution was unstable that stresses the significance of
2
the use of the elements of the null space of J. For the JJ T -based approach
no well converging solution was found.
Quasi-Differential Approaches in Inverse Kinematics 9
Fig. 3. The original [J T J-based] solution for links of periodically varying lengths (the
dilatation factor ∈ [1.0, 1.5]) in the trajectory generation. (The trajectory generated
by the dilated links not everywhere can be reproduced by a construction made of
shorter links. In such points the tracking error and the orientation error is large.)
Fig. 4. The original [J T J-based] solution for links of periodically varying lengths (the
shrinking factor ∈ [0.5, 1.0]) in the trajectory generation. (The trajectory generated
by the shrunk links can be reproduced by a construction made of longer links.)
4 Conclusions
In this paper three possible variants of the matrix inversion-free, fixed point
transformation-based quasi-differential solution of the inverse kinematic task of
open kinematic chains was investigated. It was found that the best solution
10 B. Csanádi et al.
can be obtained by transforming the original f (q) = x problem into J(q)f (q) =
J(q)x. The computations revealed the practical significance of using the elements
of the null space of the Jacobian J(q) in the continuity and stability of the
obtained solution.
Acknowledgments. This work has been partially supported by the Doctoral School
of Applied Informatics and Applied Mathematics of Óbuda University.
References
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subject, how to diagnose, not alone hyperæmia and anæmia of the
brain and spinal cord, but also of special lobes of the former and
particular columns of the latter. These directions are in most
instances based on assumptions which are not supported by direct
or tangible evidence, and the consequence is that they have failed to
stand the tests of experience, where this gauge is applicable, and
necessarily failed to advance in any way either our theoretical or
practical knowledge of those states of the brain mechanism which
are due to alterations in its nutrition.
16 I am unaware of the record of any case where aphasia occurred with ligature of the
right common carotid artery. There is a singular observation by Hagen-Torn of
permanent paralysis of the right hypoglossal nerve after such an operation, but the
report to which I have access does not state whether this may not have been due to
some peripheral involvement of that nerve.
Anæmia of the brain may develop at any period of life, not excluding
the intra-uterine period. Kundrat and Binswanger regard the
deformity of the brain known as porencephaly as the result of an
anæmic (non-embolic) necrosis of brain-substance, developed either
in the fœtal or the infantile period. The occasional symmetry of the
deformity is in favor of this view. That there are other conditions of
cerebral malnutrition,21 masking themselves in defective
development and imperfect isolation of the conducting tracts, and
that the consequent differing rate of maturation of these tracts has
some relation to the absence or presence of a predisposition to
chorea and other disturbances of nervous equilibrium so common at
this period of life, I regard as at least probable. But it is at the period
of puberty that we encounter the most important discrepancies
between the requirements of brain-nutrition and the furnished blood-
supply. The disposition to uncomplicated cerebral anæmia is
greatest at this period of life and in the female sex. Beneke22 has
shown that as the human being grows the arteries, which in children
are very large in proportion to the length of the body, get to be
relatively smaller and smaller toward the period of puberty—that
after this period they widen to again attain a large circumference at
old age. There is thus added to the other and more obscure factors
which may determine general anæmia at puberty a diminished
calibre of the arteries in both sexes. To some extent the
disadvantageous influence of (relatively) narrow vascular channels
may be overcome by increased cardiac action, and the almost
sudden increase in size of the heart about this period is probably the
result of the demand made upon its compensatory power. But, as we
learn from the same observer that the female heart remains
relatively as well as absolutely smaller than that of the male, we can
understand why the female should be less able to overcome the
pubescent disposition to cerebral (and general) anæmia than the
male. Menstruation, which in a certain proportion of girls scarcely
maintains the semblance of a physiological process, acting rather as
a drain than a functional discharge, is added to the anæmia-
producing factors. It is among those who marry in the ensuing
condition, who bring forth child after child in rapid succession,
perhaps, in addition, flooding considerably at each confinement, that
we find the classical symptoms of chronic cerebral anæmia
developed.
21 I have found in three children under fourteen months of age, who died with
symptoms not unlike those of slowly-developed tubercular meningitis, including
convulsions, strabismus, temperature disturbance (slight), and terminal coma, without
nuchal contracture or pupillary anomalies, a remarkably anæmic brain. The sulci
gaped; there were few or no puncta vasculosa; the cortex extremely pale, and the
white substance almost bluish-white. On attempting to harden the brain of the
youngest of these children, using every precaution and a sufficient number of sets of
hardening fluids, including the chromic salts and alcohol, I found that small cavities
formed in the cortex, varying from the scarcely visible to two-thirds of a millimeter in
diameter. Their existence were demonstrable the day after the death and almost
immediate autopsy performed in this case. There had been no antecedent disease in
any one of these cases; the children had been lethargic, inactive, and the oldest had
made no attempt to walk or talk. There was no morphological or quantitative defect in
cerebral or cranial development, and microscopic examination showed that the
cavities were not perivascular. In all these cases the patients belonged to the
tenement-house population.
In the male sex the period of adolescence has not the same
profound influence in producing cerebral anæmia that it has in
females. To some extent, however, habitual self-abuse and early
sexual excess of the former produce results similar to those
occurring in consequence of perverted physiological processes in
the latter. Many of the symptoms presented by the inveterate
masturbator are probably due to cerebral anæmia; there are,
however, in his case and in that of the early libertine certain vaso-
motor complications frequently present which render the clinical
picture a mixed one.23 In addition, abuse of the sexual apparatus has
a direct—probably dynamic and impalpable—exhausting effect on
the central nervous apparatus.
23 Kiernan of Chicago has described peculiar trophic disturbances—dermato-
neuroses, color-changes of the hair, etc.—in a case of masturbatory mental trouble
associated with marked anæmia. The patient whenever he flushed up heard a noise
as of a pistol snapped near the mastoid region. In the case of a young man of
eighteen who—the pampered son of wealthy parents—became his own master at
fifteen, and had at that age indulged in sexual orgies which were continued to an
almost incredible extent, it was found that he gradually lost his memory, and on one
occasion had a violent epileptiform attack. During his convalescence from the
stuporous state which followed it was noted that the patient was quite bright in the
morning, but that after he had been up a while he relapsed into a state of apathy, with
amnesia, which, decreasing in intensity from week to week, was eventually only noted
toward evening, and finally disappeared, the case terminating in complete recovery.
The purest form of acute cerebral anæmia, aside from that produced
by surgical interference with the cerebral circulation or extensive
hemorrhages, is that induced by mental influences, such as fright, a
disagreeable odor, or a disgusting or harrowing spectacle. Some
persons, not suffering from general anæmia or any diseased
condition thus far mentioned, on experiencing the emotional
influences named will be observed to turn pale, to breathe heavily,
and either sink into a chair or fall on the floor partly or entirely
unconscious. They are then suffering from a spasm of the cerebral
arteries resulting in acute and high-graded cerebral anæmia or
syncope. This condition is marked by some of the symptoms
previously mentioned as occurring with bilateral ligature of the
carotids: thus, the feeling of oppression on the chest, vertigo,
heaviness of the limbs, nausea, and vomiting are characteristic; a
cold sweat breaks out on the forehead; the visual field becomes
darkened; and hearing is rendered difficult by the tinnitus.25 The
pulse is small and of low tension, but regular.
25 Most authors claim that the sense of hearing is blunted, as that of vision is. This is
so in some, but certainly not in a large number of other cases. I have now under
observation a girl whose physical conformation—her neck is very long and her
shoulders tapering—and extreme susceptibility combine to favor the occurrence of
syncope. She faints in my office whenever an examination is made, even though it be
entirely verbal; and after recovering frequently lies down to answer by deputy, as
experience has shown her that she is less likely to faint in this position. I have
repeatedly satisfied myself from her subsequent statements that she heard what was
said, while she appeared to be quite unconscious and “saw everything black or
through a cloud.” It is not improbable that the impressions which most writers on the
subject convey were derived from the experience of novices in fainting; these, in the
alarm and anxiety of their condition, and confused by the tinnitus, might well fail to
hear what the bystanders said, particularly as on many such occasions the fainting
person is apt to be surrounded by a confused Babel of tongues. While the auditory
nerve is as sensitive to the irritative influence of anæmia as any, and there is a case
of a boy on record (Abercrombie) who could only hear well when lying down, and was
deaf when he stood up, yet the conclusions of other authorities who have studied the
subject would lead one to think that there are individual differences in this respect.
How often does not the dying person, after feeling for the hands of a relative whom he
cannot see, converse with him responsively! And how much need is there not of the
humane physician to remember that the sense of hearing is the last intellectual sense
to die, lest he speak unguardedly at the bedside!
28 Up to within a very short time ago it would have appeared heretical to claim that
any considerable amount of brain-wasting could ensue from starvation alone, as the
oft-cited experiments of Chossat seemed to show that mammals, birds, reptiles, and
amphibians lose in body-weight while being starved, but that the brain-weight is not
disturbed to any appreciable extent. Six years ago I examined the brain of a tortoise
(Cestudo Virginica) which had starved fully a year through ignorance of the keeper of
an aquarium. The atrophy of the brain was so marked that it had undergone
demonstrable changes of contour. Since then Rosenbach (Archiv für Psychiatrie, xvi.
p. 276) has demonstrated that brain-wasting and other changes do occur in starved
rabbits.
The radial pulse in cerebral anæmia does not necessarily show the
anæmic character; not infrequently the general blood-pressure is
increased at the onset of the acute form, and if long continued this
may be followed by a decrease of the same. The pulse-character
may therefore vary greatly in frequency, resistance, and fulness. In
protracted cases it is soft, easily compressible, and rapid.
31 It should not be forgotten, however, that very similar symptoms occur after cholera
infantum, with a much graver pathological condition—namely, marantic thrombosis of
the sinuses.
One of the gravest and rarest forms of cerebral anæmia is one which
occurs as a result of extreme general anæmia in very young infants.
In a remarkable case which I have had an opportunity of studying,
the abolition of certain cerebral functions reached such a degree that
the opinion of a number of physicians was in favor of tubercular
meningitis.32 There was at the time of my examination complete
extremity hemiplegia, and there had been conjugated deviation,
restlessness in sleep, and dulness in the waking hours: all these
symptoms except the hemiplegia disappeared whenever a more
assimilable and nutritious food was used than the one previously
employed. On one occasion there were evidences of disturbed vaso-
motor innervation; on several, convulsive movements. This history,
associated with ordinary evidences of general anæmia, covered a
period of eighteen months, without the slightest abnormality of
temperature being noted or discoverable during that period. The
mucous surfaces of this child were almost colorless, certainly without
any indication of the normal tinge; the mother had nursed it, and her
milk had been found to possess scarcely any nutritive value. The
case terminated fatally at the age of twenty months.
32 It was stated by an experienced practitioner that death occurred with unmistakable
symptoms of tubercular meningitis. Certainly, the absence of temperature disturbance
at the time of the hemiplegic and other exacerbations, as well as other important
features for a period exceeding a year, shows that whatever favorable soil the earlier
condition may have furnished for the secondary development of such or other gross
structural disease, tubercular meningitis did not exist at the time; while the absence of
pupillary and optic-nerve symptoms, as well as the rapid changes from day to day or
week to week under dietetic treatment, militate against the assumption of any other
organic affection incident to childhood.
Partial Cerebral Anæmia.—Most writers on cerebral anæmia discuss
a number of varieties of partial cerebral anæmia as distinguished
from the acute and chronic general forms. Some of the conditions
thus described properly appertain to the angio-spastic form of
hemicrania, others to epilepsy, and the majority to circulatory
disturbances dependent on arterial disease. Aside from the partial
cerebral anæmia resulting from surgical causes, I am acquainted
with but one evidence of limited cerebral anæmia which can be
regarded as independent of the neuroses or of organic disease, and
that is the scintillating scotoma. This symptom, in the only case in
which I observed it, occurred in a medical student, accompanied by
pallor and nausea in consequence of the disgust produced in him by
the combined odors of a dissecting-room and of a neighboring
varnish-factory. The totally blind area of the visual field was strictly
hemianopsic in distribution and bounded by a colored zone
scintillating, to use the sufferer's words, like an aurora borealis. The
attack, probably protracted by his great alarm at being blind in one-
half of the visual field, lasted three hours. As the cause in this case
was a psychical impression and accompanied by the ordinary signs
of that fainting which is not an uncommon occurrence in the
dissecting-room; as, furthermore, the individual in question never
had a headache except in connection with febrile affections, and
then in the lightest form, and is neither neurotic himself nor has a
neurotic ancestry or relatives,—I regard it as the result of a simple
arterial spasm intensified in the visual field of one hemisphere,
analogous to the more general spasm of ordinary syncope.33
33 It may be remembered that Wollaston had scintillating scotomata, and that after his
death a small focus of softening was found in the one visual field. Ordinarily, this
disturbance is associated with hemicrania.