Intracerebral hemorrhage in the young / by B. Sachs.

  • Bernard Sachs
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Intracerebral hemorrhage in the young / by B. Sachs. 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.

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    there are conditions which rarely lead to the post-mortem table and yet are of commanding interest. Moreover, in the present state of cerebral pathology we are, I claim, fully able to infer path- ologicial appearances from clinical data. The clinical data, and the inferences drawn therefrom, must be beyond dispute. You will find a close resemblance between the histories here pre- sented to you and that of an ordinary adult apoplexy. This striking analogy may be taken as one proof of the identity of the pathological processes. The details of my first case are as follows : Case I.—One of three children ; good family history ; no syphilis. The patient, M, M.,is a healthy-looking boy two and a half years old. Up to the time of present illness in October, 1885, boy had had no other diseases but chicken-pox, eczema, and one and a half years previously, inflammation of the lungs. No history of fall. October 24th I was called to see the child and was told that it had been restless the night before, that it had vomited once, and seemed to have some difficulty in swallowing its food. Inspection showed that the tonsils were considerably swollen, the tongue slightly coated, but there was nothing of a diphtheritic character visible on or about the tonsils. The rectal temperature was 101.4.° During the next few days the tonsillar symptoms abated under the ordinary iron treatment. The temperature never exceeded 102°, and the pulse varied between 90 and no. I saw the child on the morning of the 27th, found all its symptoms in abeyance, the child moved about freely, was feeling well and answered ques- tions in its childish way, played with its toys, and did not seem in need of further medical attendance. Early the following morning, the father called upon me in great distress, saying that his child could not speak and that it was not able to move its right side. My first fear was that the throaty trouble had perhaps been of a more serious character, and that the child was now afflicted with a form of diphtheritic paralysis ; but on seeing the patient I rid myself very quickly of this no- tion, for to my knowledge diphtheritic paralysis is never of the hemiplegic order. At the patient’s house I learned the following : On the day pre- vious, soon after I had left the child, the latter seemed to grow very quiet; the nurse was struck by the fact that the child had given up calling her name dozens of times in succession as had been its habit; she did not remember having heard a single word pass the child’s lips since that morning. No further attention was paid to the matter, as the mother and nurse thought the child sullen and nothing more. The nurse claims that the child used its arms perfectly well during the day, that it climbed of its own accord from one bed into another about 8 o’clock in the evening. At about lo o’clock the mother noticed that the child moved its left arm and not its right, and the nurse noticed during the night f hat the child embraced her with its left hand only, that it lay on