UC SOUTHERN REGIONAL LIBRARY FACILITY G 000 005 534 3 S456| 1883 L oi i V < , • J. *, ' < I, ;J1W3-J0' IIIYHHIT '-^ c<^ ^>uivy: 'Tt: 4* GUDDEN'S ATROPHY METHOD: AND A '^ SUMMARY OF ITS RESULTS BY E. C.i^GUIN, M.D. COXRESrONUING MEMBER OF THE " VEREIN FUR INNERE MBDICIN " OP BERLIN [Reprinted from the Archives of Medicine, Vol. x, Nos. 2 and 3, 1883] G. P. PUTNAM'S SONS NEW YORK : 27 & 29 WEST 23D STREET LONDON : 25 HENRIETTA STREET, COVENT GARDEN 1883 ^ T^AilT GUDDEN'S ATROPHY METHOD: AND A SUM- MARY OF ITS RESULTS. By E. C. SEGUIN, M.D. MUCH as we honor the discoverer of a new fact of importance or of a series of facts, we owe much more to him who places at our disposal a new method, one sufficiently tried to merit adoption at our hands. A method is a chapter of applied logic, pregnant with possible results of unknown importance. And this is not its only value, for, as a part of the logic of science, it also serves a purpose in scientific speculation, and almost inevitably gives rise to new ideas, to other methods, by analogy or by deduction. Gudden's atrophy method, one of the anatomical methods applied to the study of that obscure field of re- search — the central nervous system, — lay hidden, most un- fortunately, in the possession of its originator and a few pupils, for nearly thirty years, and even since its publica- tion in 1872, it has been but little noticed outside of a very small circle of neurologists.' Yet, I think that the follow- ing abstract will show it to be one of the most important and promising of the various special anatomical methods.* From 1850 to 1852 Augustus Waller was at work in Budge's laboratory at Bonn, perfecting his method of study- ing the degeneration of severed nerves. The facts of de- generation and regeneration after nerve-section had been long known, but it remained for Waller to formulate the * In the most recent scientific work on anatomy (Burt G. Wilder and Gage, "Anatomical Technology," New York, 18S2), containing a remarkably full 'bibliographical index, the name of Gudden does not appear. " The special anatomical methods applied to the study of the central nervous Reprinted from the Archives of Medicine, Vol. x, No. 2, October, 1883. 2 GUDDEN'S ATROPHY METHOD. law under which the degenerative process occurs. In his '' Noiivelle m^thode anatomique,'' Bonn, 1852, he gave a full summary of the facts and laws he had discovered, and they have been common property ever since, leading to numerous important anatomical and pathological discover- ies. The doctrine of the Wallerian degeneration, has, I may say, been a valuable instrument in our hands for thirty years. At the very same time, 1849, Gudden, a recent graduate of the University of Berlin, then assistant physician in the Siegburg insane asylum under the celebrated Jacobi,was ex- perimenting upon the brains of animals in a different, yet correlative, manner. He had already extirpated eyes of rabbits, and noted the atrophy of the intracranial optic ap- paratus; he already knew the tractus peduncularis trans- versus, and many of his subsequent discoveries were half developed.* This was done in ignorance of Waller's work, and partly before it ; certainly long before Tiirck's publica- tions on secondary degenerations. For reasons best known to himself. Professor von Gud- den did not publish an account of his method until 1870,^ although his principal facts and laws had long been known to him, and he had communicated freely with friends and assistants, so that we have here a striking example of the simultaneous discovery of facts, laws, and methods which, applied to the same division of the animal frame, are in themselves not very unlike, and in their results are logically united, and, indeed, complementary to each other. system are : (a), The dissociation or dissection of fasciculi in partially hardened specimens, as practised by older anatomists, by Foville, Gratiolet, Broadbent, and many others (nearly disused); (b), the Rolando-Stilling method of series of fine sections of the hardened organs ; (c), the Wallerian degeneration in ani- mals ; (d), the Tiirck secondary degenerations in man (and in animals); (e), Flechsig's method of determining the period at which certain systems of fibres in the foetus acquire myelin. ' Oral communication from Prof. v. Gudden, August 4, 1883. ^ Experimentaluntersuchungen iiber das peripherische und centrale Nerven- system. WesphaFs Archiv, Bd. ii, p. 693. E. C. SEGUIN. 3 I purpose in the following pages to enunciate the central principle of Gudden's method, and then to analyze his pub- lications and those of his pupils, more or less in chrono- logical order with reference to publication. Besides con- sulting these publications, I have had the advantages of conversing with Prof. Gudden and several of his pupils, and of examining the specimens proving the statements advanced in nearly every case. Principle : TJiat by experimenting on neivly-born animals, especially those zvhich, like the rabbit, are brought forth in a sometvJiat fcetal state, complete atrophy of the central connec- tions of a nerve-trunk, or a nerve-fasciculus, or a nerve- centre, is obtained by operation. The central {proximal) fibres and cells are destroyed, ivJiile the peripheral fibres, if any, undergo the Wallerian degeneration. There are several secondary advantages in using very young animals; they (rabbits at least) have almost no hair; they suffer but little pain, and scarcely struggle under the knife ; they bear the shock of incision and removal of important parts of the central nervous system wonderfully well ; haemostasis is in them very rapid and definite, and the process of repair simple. For operations on nerve-trunks, almost any animal can be used. For experiments on intracranial parts, dogs are objectionable because of their hard craniums ; kittens are intermediate between rabbits and dogs in this respect, but they are liable to suppuration, and the mother is apt to interfere with the sutures. Most operations should be done on the second or third day of life, but may succeed later; still, the older the animal the more the Wallerian law of degeneration in one direction (centrifugal from centre) only prevails. For most operations on the olfactory apparatus it is 4 GUDDEN'S ATROPHY METHOD. necessary to wait until the animal (rabbit) be six or seven days old, in order to give time for the ears (hearing and tactile sense) to develop sufficiently to enable the creature to guide itself and find the mother. For operations on the hypoglossal and vagus nerves one must wait still longer, from the second to the sixth week/ The various operative procedures will be described under the several heads of this review, but it is well to state here that the lesion should be a destructive one ; the olfactory lobe or eyeball must be removed, or in the case of nerves, their central ends after section must be pulled out of their bony canals with good forceps. In the case of nerves in newly-born animals, so much comes away by this method that there is reason to believe that some axis-cylinders are broken off deep in the nervous centre from which they spring. It is possible that some of Gudden's operations give results as much by degeneration as by simple atrophy ; in other words, that his and Waller's method overlap each other. In this connection let me say that the histology of the early period of Gudden's atrophy is unknown, which is a deplorable hiatus in our knowledge. From a study of this point we may learn something of the obscure point referred to, viz., the true relation between the two methods, and obtain new light on so-called " trophic " laws of the nervous system. The operated animals are left to the mother's care, and allowed to grow from six to twelve weeks ; , the former period being quite sufficient for most experiments. Indeed, Gudden has shown ^ that after removal of one eyeball in dogs one day old, distinct atrophy of the optic nerve was ' Oral communication from Prof. v. Gudden. ' Archiv f. Ophthalmologic, Bd. xxv, Heft 4, pp. 237-246, 1879. E. C. SEGUIN. 5 visible on the 8th, 14th, and 28th days. In rabbits a dis- tinct atrophy may be visible in 36 hours after operation on second day/ During this period of preservation, the animals should be carefully studied as to their functions, with especial reference to the injured apparatus, and compensatory func- tions. By doing this in as careful a manner as Munk has done for his cortex experiments, some physiological and psychological knowledge might be gained from each series of operations. This has been done, but not as fully or exactly as should be. After the animals are sacrificed, the affected parts should be carefully examined for asymmetry, change in color and consistence. If possible, photographs of the fresh speci- mens should be taken, and careful measurements of parts made. The organs are then placed in a solution of bichromate of potassium, or of osmic acid, for hardening. When this is complete the various sections necessary to reveal the direction and extent of central changes are made and preserved in accordance with well-known methods. It is often desirable to have complete series of sections through the whole organ or a portion of it, so as to enable the exact extent and distribution of the atrophy to be fol- lowed. In such cases the use of Gudden's microtome is necessary. The sections should be thin enough to allow of their examination by |- or -|- inch objectives. Usually trans- sections show the lesion well, but in some cases (olfactory part of anterior commissure) longitudinal dextro-sinistral sections are necessary. The condition of the atrophied centres may be roughly stated as follows: As an example, after extraction of the facial nerve, a series of trans-sections of the medulla show simply an absence, a total absence, of the injured nerve- ^ Ibidejji, Bd. xxv, Heft i, pp. 1-56. 6 GUDDEN'S ATROPHY METHOD. trunk in its course through the medulla, and of its nucleus of origin. There is, architecturally speaking, a virtual void in this region, which is filled up or compensated to a degree by the ingrowth and overcrowding of adjacent normal parts. There are no exudations, thickening of neuroglia, areas of disintegration, etc., so that the topographical study of the sections and the tracing out of the atrophy are not hindered as in ordinary pathological specimens. RESULTS OBTAINED BY GTIDDEN'S METHOD. I propose mentioning these very briefly and without criticism. Many of the questions to which the experiments relate are novel and intricate ; further researches by other methods may modify the views held by Gudden and his pupils, but these views should be plainly stated so as to serve as data for other observers. Enough will be found in this abstract to justify, I think, the statement that we already owe much in anatomy and physiology to this method, and that it offers great possibilities for the future. The topics will be considered partially in chronological order. /, — Composition and connections of the commissura anterior cerebri. Von Gudden and Ganser have been able to resolve these two questions in greater part by the atrophy method. It has long been known that the c. A. consists of two unequal fasciculi, variable in different animals, and these Ganser calls (i) pars temporalis; (2) pars olfactoria. In general terms, as revealed in normal sections, the p. t. is very much larger in man and in monkeys, while in lower mammals, particularly the hedgehog, mole, and rabbit, the p. o. is highly developed and larger than the p. t. E. C. SEGUIN. 7 1. Pars temporalis. Von Gudden, in 1870/ published experiments illustrating the nature of the pars temporalis. ExPT. — In a newly-born rabbit the whole upper part of one cerebral hemisphere was excised, above the basal ganglia. Autopsy at eight weeks showed the commissura anterior normal. ExPT. — In another rabbit the whole of one hemisphere was removed. Seven weeks later the animal was killed, and sections of the (hardened) brain showed complete atrophy of the commis- sura anterior. The external capsule was, however, preserved in the remaining hemisphere. In both experiments there was atrophy of the corpus callosum, complete in the latter. Conclusions : the temporal division of the C. A. is a true commissure, as is also the corpus callosum. The external capsule has no direct connection w^ith the C. A. These experimental results have been confirmed by Ganser. The conclusions are, moreover, supported and ex- tended by the result of the careful study of complete series of brain sections of man, monkey, and lower mammals, made by Ganser.'' The sections were transverse and horizontal, and in them the course of the C. A. (its pars temporalis) was always distinctly into the temporal lobe, be- yond the nucleus amygdalus. No fasciculi going to other parts of brain (occipital lobes, Meynert et al.) could be discovered. 2. Pars olfactoria. Von Gudden experimented on this also, but his conclusions were invalidated by a source of error discovered later on. It is to Ganser (op. cit.) that we owe the absolute demonstration of its true nature and distribution by means of von Gudden's method. * Experimentaluntersuchungen uber das peripherische und centrale Nerven- system. Westphal' s Archiv, Bd. ii, p. 693, experiments v and vi. " S. Ganser : Ueber die vordere Commissur der Saugethiere. Westphal' s Archiv, Bd. ix. Heft 2, 1878. 8 GUD DEN'S ATROPHY METHOD. ExpT. — The brain of two rabbits formerly operated by von Gudden were cut into complete series of horizontal and transverse sections. The injury consisted in destruction of the left tractus olfactorious and frontal part of lobus pyriformis with a por- tion of adjacent (dorsal) frontal lobe. The left bulbus olfac- torius (lobus olf.) was very much atrophied. In both sets of sec- tions (the horizontal best adapted) there was complete absence of the olfactory division of the c. a. ExPT. — Two other rabbits from whom von Gudden had re- moved one of the bulbi olfactorii. These brains were shrunken and overhardened, yet fairly good sections were obtained, enough to show that in these two cases also there was complete atrophy of the p. ol. of the c. a. Conclusions : the pars olfactoria of the C. A. is also a true commissure, and unites the two bulbi olfactorii. Thus, by a few simple experiments and careful observa- tions (objectively carried out) of preparations, is that fanciful fabric, Meynert's olfactory chiasma overturned. //. — Commissiira inferior cerebri. Almost from his earliest experiments on the optic appara- tus, von Gudden had observed that after removal of both eyeballs, a portion of the chiasma and of the optic tracts did not undergo atrophy. In his first published accounts ' of the structure of the optic nerves, etc., he formulated this observation by naming the surviving or non-atrophied nervous band, commissura inferior cerebri, and expressed the opinion that it was a commissure between the thalami. In the first of his series of contributions "^ in Grczfe's Archiv, these preliminary demonstrations are repeated. In the third contribution, Mn reply to certain statements of Michel, ' Experimentaluntersuchungen iiber das peripherische und centrale Nerven- system. WestphaVs Archiv, Ed. ii, p. 693 (1S70). Sitzung der viii Versammlung der Schweitzarischen Irrenserzte (Sept., 1872), abstract in Psychiatrische Zeitschrift, Bd, xxx, p. 135. ^ Ueber die Kreuzung der Fasern im Chiasma Nervorum Opticorum. Archiv f. Ophthalmologie, Bd. xx, Heft 2. pp. 249-268, 1S74; The second contribution is in Bd. xxi, Heft 3, pp. 199-205, 1875. ^ Idem, Bd. xxv, Heft i, pp. 1-56, 1879. E. C. SEGUIN. 9- he insists upon the distinction between this fascicuhis and the one known as Meynert's commissure, which is distinctly dorsal of the chiasma, and separated from it. The commissura inferior, on the contrary, is mingled with the tractus opticus and can only be discerned by excluding the fibres of the latter, which is easily done by removal of both eyeballs in the young animals, thus producing atrophy of all the truly optic fasciculi. Sometimes in the rabbit, dog, and cat, a slight depression in the caudal-ventral aspect of the chiasm suggests its limits. In trans-sections of rabbits' tractus opticus no special limit is discernible; but it is noticed that while the optic fibres are coarse, those of the C. I. are fine. If one of these trans-sections be treated with alcohol and then with carmine the portion belonging to the C. I. is strongly tinged, while the optic fibres remain white. The same reaction has been obtained by Mayser in the T. O. of cyprinoid fishes. In dogs, cats, monkeys, and man no such chemical distinction exists. If the sections of rabbits' T. O. are placed unstained (only colored by potassium bichromate) in glycerine, the fibres of the C. I. appear as forming a clearer mass in the dark field of the optic fibres. In his fourth optic contribution,' von Gudden describes the appearance of the optic apparatus in a human case of long-standing one-sided blindness. Those parts in the chiasma and tractus optici which correspond to the C. I. he found unchanged, but not distinctly limited, and made up of fibres having the same diameter as the optic fibres. The C. I. in these trans-sections was dorsal of the optic fibres. In the chiasma of animals it occupies the caudal, or the caudal-ventral, aspect. In his " Experimentaluntersuchungen," he states, that ^ Archiv f. Ophthal., Bd. xxv, Heft 4, pp. 237-246, 1879. lO GUDDEN'S ATROPHY METHOD. the study of numerous trans-sections of the brain has shown that the commissura inferior extends into the thalami optici, connects them, and is probably in no wise associated with the optic apparatus. After destruction of the lobus opticus and the corpus geniculatum laterale, the commissura infe- rior remains unchanged. In connection with these important studies upon the commissural systems of the brain (corpus callosum, com- missura anterior, and commissura inferior) von Gudden has formulated the following law of atrophy (of nutrition) : That a true commissure, separated from one of its attach- ments, must undergo bilateral atrophy. UA^. III. — Distribution of fibres in the optic apparatus. As stated in the four articles in Grcefe's Archiv, von Gud- den has reached the following conclusions : 1. That in birds there is complete decussation of fibres in the optic chiasma. ExpT. — Removal of one eyeball in a pigeon immediately after birth. Autopsy in eight weeks showed atrophy of optic nerve of same side, extending across the woven chiasm to the opposite optic lobe, which is much reduced in size. 2. In the higher mammalia the decussation is variable, but is always a semi-decussation. ExPT. — In a rabbit,* the right eyeball was enucleated. Results : {a) atrophy of right optic nerve ; {b) chiasma unchanged ; {c) opposite (left) tractus opticus jwuHlb, as are also {d) the lobus opticus, and {e) the corpus geniculatum laterale ; {/) complete atrophy of opposite left tractus peduncularis. Negative results : post-optic lobes (corpus quadrigeminum inf.) and commissura inferior normal. This experiment seemed to show that there was complete ' It was always in newly-born animals that the various operations were done. E. C. SEGUIN. II decussation in the rabbit, and so Gudden held for some years, but different experiments, published in 1879,' demon- strated beyond question the existence of a direct fasciculus in the optic nerve of this animal. ExPT. — By means of a sharp spoon, the optic lobe, corpus geniculatum externum, subjacent part of caudex, and correspond- ing optic tract are removed. Autopsy at age of six months. Results : [a) total atrophy of injured tractus opticus ; {!)) oppo- site optic nerve atrophies in greater part, but still showing a small normal white fasciculus. ExPT. — The brain was lifted up, and one half of chiasm cut out with a sharp spoon. Results : complete atrophy of the optic fibres, except a small (lateral) bundle in opposite optic nerve — its direct fasciculus — (in this experiment the comraissura inferior undergoes atrophy, as does also Meynert's commissure dorsal of tractus). As complementary to these results may be added the fact that one of Gudden's assistants. Dr. Bumm,* carefully examined the retina of the eye receiving only the direct fasciculus, and found the nerve-fibre layer atrophied, except in the lateral (temporal) segment of the organ. The retina was hardened in osmic acid, and the whole of it cut and prepared. Consequently, it must be held as demonstrated that in rabbits there is semi-decussation, but to a slight degree only, as the crossed fasciculus is enormously larger than the direct ; and that this small direct fasciculus supplies the temporal part of the retina in 'ologifti r/V^ ExPT. — Right eyeball enucleated. Results : {a) complete atrophy of right optic nerve ; \b) both optic tracts reduced in size, the left smaller ; {c) both optic lobes smaller ; {d) both / / corpora geniculata laterala smaller ; {e) caudal ^^^^ of /^ thalami smaller ; (/) tractus peduncularis smaller. The commis-^ sura inferior was preserved. ExpT. — " Optic centres " (lobus opticus and corpus genicu- ^ Arch. f. Ophthal., Bd. xxv, i, pp. 1-56, 1879. " Bumm : Ueber die Vertheilung des Sehnerven in der Netzhaut des Kanin- chens. WestphaVs Arckiv, Bd. xi, p. 264, 1881. 12 GUDDEN'S ATROPHY METHOD. / latum laterale) removed on right side. Results : («) tractus op- ticus of same side atrophied ; (^) both optic nerves reduced in size, opposite (left) smaller ; {/) commissura inferior preserved. In dogs, consequently, there is also semi-decussation, to a greater extent than in rabbits, but still the direct fasciculus is smaller than the crossed. The course of the direct fasciculus in the dog (as seen in horizontal sections of chiasm from above experiment), lies in the dorsal border of right tractus opticus;' reaching the chiasm it passes over the crossed fasciculus from the other tractus, and then farom the medial border of the optic nerve on same side (right). In rabbits this fasciculus lies in the lateral border of optic nerve. Numerous experiments of these kinds are recorded in the various papers, and elaborate measurements given of the areas of the affected optic nerves and tracts. Gudden formulates the law of atrophy in the. optic ap- paratus as follows : 1. The optic nerves and tracts degenerate (undergo atrophy) when the retina is destroyed (removed). 2. The " optic centres" (lobus opticus and corpus geni- culatum laterale) also undergo atrophy in such a case. 3. When the centres are removed, the degeneration does not involve the retina. In man, reasoning by analogy from the higher mammals experimented on it, would seem that semi-decussation were a logical necessity, yet several advocates of complete decus- sation have appeared.' The|# arguments have, however, been very weak, and Gudden made short work of their few experimental claims.^ Cases of long-standing monocular blindness in man, fitted for the direct solution of the prob- lem, are not infrequent, but few of them have been properly ' Chiefly Michel, Arch. f. Ophikal., Bd. xxiii, Heft 2, pp. 213-226, 1877. "^ Arch. f. Ophthal., Bd. xxv, Heft I, pp. I-56, 1879. E. C. SEGUIN. 13 studied. Von Gudden has had the opportunity of examin- ing four such cases. Case i. — Man eighty-five years old ; blind in one eye from early youth : phthisis bulbi. The atrophy is not total, many normal nerve-fibres being found in affected optic nerve. Both tractus smaller than normal. Case 2. — Man thirty years old ; complete atrophy of left optic nerve (not one fibre found in a careful microscopic examination) ; both tractus reduced in size, one on opposite side smaller. Case 3. — Male, dying at sixty, with left hemiplegia. Thirteen years previously had had an attack of " apoplexy." Besides the lesion in one internal capsule explaining the hemiparesis, there was found an old hemorrhage which had destroyed the left corpus geniculatum laterale, part of the thalamus opticus, and part of the tractus opticus. The whole tractus was atroyjhied ; the oppo- site optic nerve smaller, and the nerve on same side contained many atrophied fibres, and was smaller (on section) in its medial and central fasciculi. (The case is obscurely reported, and there seems to be an error in the designation of the optic nerves.) Case 4.' — Woman, aged seventy-three years. Glaucoma and complete loss of sight in right eye for four years. The right optic nerve was completely atrophied ; the right tractus opticus seemed normal to naked eye ; the left tractus was smaller and mostly gray ; on the chiasma itself, and upon the left tractus, crossing chiasm from the frontal medial border of left optic nerve, was a projecting white band, the direct fasciculus from left eye. The microscope showed the left tractus all gray except in its dorsal aspect, where some normal nerve-fibres were seen ; the right tractus, on the other hand, presented (in sections) only a small area of atrophied fibres (the direct fasciculus from the right eye, and the commissura inferior). The degeneration and atrophy extend to the optic centres, /. e., the left corpus genicula- tum laterale and lobus opticus. These cases certainly favor the theory of semi-decussation. The following is a general sun:imary of von Gudden's re- sults with respect to the optic apparatus. I. That Johannes Miiller's law (which was only a physio- logical postulate), that in animals whose visual axes are ^ Arch. f. Ophthal., Bd. xxv, Heft 4, pp. 237-246, 1879. 14 GUD DEN'S ATROPHY METHOD. only lateral (monocular vision) there is total decussation, and that in animals whose visual axes are more or less di- rected forward (more or less perfect binocular vision) there is semi-decussation, is a good law, supported by his (Gud- den's) experiments and other facts. 2. That there is no anterior commissural (inter-retinal) fasciculus in the optic apparatus, 3. That the posterior commissural fasciculus of classic authors is his commissura inferior, which has no relation to the optic system. 4. That the optic system in mammals consists only of two bundles or fasciculi, one crossed and the other direct ; the former the larger in rabbits, dogs, and cats (and quite certainly in man). 5. That there is an accessory optic fasciculus, whose cen- tral and peripheral terminations are yet unknown, viz., the tractus peduncularis transversus. 6. That each optic tract is composed of three sorts of fibres, of the same size in man, of different sizes and differ- ent carmine reaction in animals ; optic fibres (crossed and direct), fibres of the commissura inferior, and " hemispheric fibres," whose course is not well known. These last- named fibres are in the most lateral part of the tractus and pass into the crus cerebri. These results were confirmed by the experiments of von Gudden's pupil — Ganser — on cats, published last year.' This able observer has also carried the inquiry further, as regards the cortical and retinal distribution of optic fibres, affording a remarkable concurrence between von Gudden's results and Munk's. Ganser chose cats, for several reasons. They are vigorous under operative interference ; they are more intelligent ^ Ueber die periphere und centrale Anordnung der Sehnervenfasern und iiber das Corpus bigeminum anterius, Westphal's Archiv, Bd. xiii, Heft 2, 1882. E. C. SEGUIN. 15'. than rabbits, so that one can test their visual field ; they have, to a remarkable degree, binocular vision, and thus re- semble man ; their retina has a very high and clearly de- fined structure, thus affording excellent opportunity for ophthalmoscopic and microscopic study. He relates three crucial experiments as follows : ExPT. I. — For the determination of the direct fasciculus. On the third day after birth, the left eyeball of a kitten was enucleated. A fine forceps was introduced through the foramen opticorum, and the tractus opticus of the same side torn or cut (at the same time unintentionally a slight wound was made in the infundibulum and left internal capsule). Cat recovered quickly and grew normally ; was, however, lazy or stupid, more so than a brother kitten who- had lost one hemisphere. Vision seemed good till tested, when it was found it had hemianopsia, /.