A case of double optic neuritis without cerebral tumour / by J. Hughlings Jackson.
- John Hughlings Jackson
- Date:
- [1897]
Licence: Public Domain Mark
Credit: A case of double optic neuritis without cerebral tumour / by J. Hughlings Jackson. Source: Wellcome Collection.
Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)
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![who was transferred from my care to that of Dr. Fuller, and who had choked discs of the most typical character. Dr. Huglilings Jackson saw him, and entertained no doiiht that he was the subject of some form of brain disease: and the same opinion was expressed by Dr. Xoyes, of New York, and by several members of the International Ophthal- mological Congress, which was then assembled in London. The l)dy died of pleurisy supervening upon advanced kidney disease, and no trace of mischief in his brain could be discovered by the most careful examination. Xearly at the same time we had in the Hospital a young woman whose eyes presented typical examples of the changes often associated witli albuminuria, but who died with healthy kidneys, of a tumour in the cerebellum. One peculiarity in the case lam about to relate is the absolute amaurosis. This is a rare thing'in physicians' practice. I rarely see such discs as this patient had, with loss, or even with extreme defect, of sight. On the other hand I very often see optic neuritis without impairment of vision. The patient was sent to me by ]\Ir. James Adams, it was then essentially an ophthalmic surgeon's case. I w^ould say, too, that during the woman's hfe I had no doubt that we should find an intra-cranial tumour (or other kind of coarse disease). I ought to have been less confident, because I once before felt certain that I should find an intra- cranial tumour in a case of double optic neuritis, and found only general cerebral atrophy; there was no adventitious product, nor any trace nor relics of it. I did not examine any of the brain of that patient microscopically. In the case about to be narrated we cannot invoke raised intra-cranial pi'essure as a cause, for there was no evidence of it; the congestion of the brain was certainly no evidence of it; it was simply owing to the mode of death. I cannot do better here than quote what Wilks and Moxon say of cerebral congestion. There is no doubt that congestion of the l^rain is the cause of serious symi)toms, and even of death. AVe particularly ask](https://iiif.wellcomecollection.org/image/b21637039_0010.jp2/full/800%2C/0/default.jpg)
