Ophthalmology and diseases of the nervous system, being : the Bowman Lecture, delivered Friday, November 13th, 1885 / by J.Hughlings Jackson.

  • Jackson, J. Hughlings (John Hughlings), 1835-1911.
Date:
[1885?]
Catalogue details

Licence: Public Domain Mark

Credit: Ophthalmology and diseases of the nervous system, being : the Bowman Lecture, delivered Friday, November 13th, 1885 / by J.Hughlings Jackson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    11/24 (page 9)
    most cases they were secondary to embolism or thrombosis of small arterial branches; that there were “ arterial cortical lesions ” in most epilepsies. He had held that some epileptiform seizures have that pathology since 18G4 London Hospital Reports/ vol. i, p. 465), and considered that some cases recently published by different physicians proved that hypothesis. The researches of Duret and Heubner on the detailed arterial supply of parts of the brain will enable us to be more definite in our arterio- cortical localisations of “ discharging lesions,” especially in epileptiform seizures; some cases of this kind were evi- dently owing to blocking of branches of the middle cere- bral. Another way of putting part of the foregoing is to say that epileptiform seizures do not always depend on tumour. This brings us again close to ophthalmology. If anyone is thinking of removing a brain tumour in a case of epileptiform seizures, he ought to refrain from operating if he does not find optic neuritis (perhaps with one exception). Of course there are epileptiform seizures from brain tumour in which (for years at least) there is no optic neuritis, but without this eye condition we cannot (with perhaps one exception) be sure of tumour. It was from both neurological and ophthalmological knowledge that Dr. Hughes Bennett made the double diagnosis of seat and nature of the disease in the case of tumour which Mr. Godlee removed from a patient’s brain.]* [The lecturer then spoke of certain important cases of epilepsy complicated with some particular definite and persisting eye-symptoms, pointing to intracranial tumour ; the investigation by the ophthalmic surgeon of paroxysms * Since this address was given I have seriously modified my opinions on this matter. I have advised operation in the case of a man who liad epileptiform seizures beginning in his left thumb, but who had no optic neuritis and no severe headache; there were no signs of injury. Mr. Victor Horsley removed a tumour from the right cerebral hemisphere, and, at my suggestion, cut out part of the thumb centre. Mr. Horsley showed the patient at the Brighton meeting of the British Medical Association, August 13th, 1886. The man was then quite well except for some weakness of the left hand j the fundi were normal.