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.

    13/24 (page 11)
    H not left-handed; in most cases of this variety of epilepsy the lecturer thinks the one-sided phenomena, if any, are left-sided.) Having regard to an important case recorded by Mr. Nettleship ('Transactions^ of this Society, vol. iv, p. 285), like this in the optic symptoms (necropsy by T)r. Sharkey), in which there were slight epileptic fits with a feeling of suffocation refei’red to the nose and mouth, the lecturer thought that in Dr. Anderson’s patient’s case there was a basal tumour causing the epileptic fits by involving, or by in some way inducing, changes of instability in, the left temporo-sphenoidal lobe.* Cases with such fixing eye-symptoms, implying gross organic disease, for obvious reasons deserve most careful and minute investigation, not only of the eye-symptoms, but of the epileptic fits also.] Speaking now very generally of the after-conditions of epileptic paroxysms, we have insanity, according to the severity of the fits, in two degrees at least,—in three, I think. There is so-called loss ” of consciousness with actions (post-epileptic unconsciousness ” with mania, for example), and after very severe paroxysms acute dementia (coma). Here I remark that it is vain to attempt the realistic study of epilepsy and its after-conditions, or that of any other insanity, without psychological knowledge. Confounding psychology with physiology of the highest centres leads to crude metaphysical explanations, stich as that in post-epileptic coma a man does not move because ho is unconscious, although in a slighter post-epileptic condition, post-epileptic mania, there is movement enough when, according to the opinion of most, consciousness is lost. Taking post-epileptic coma after a very severe fit, there is exhaustion of more or less of the highest centres • This patient has since died, and the necropsy by Dr. Anderson showed a large tumour, partly solid, partly cystic, occupying the position of the pituitary body and extending backward as far as the pons, along the inner margin of the left temporo-sphenoidal lobe, which it had undermined. The right optic tract and optic nerve were not directly involved in the tumour, the left tract and nerve were. Papillitis developed in the right eye shortly before death.