Nervous diseases : their description and treatment / by Allan McLane Hamilton.

  • Allan McLane Hamilton
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Nervous diseases : their description and treatment / by Allan McLane Hamilton. Source: Wellcome Collection.

    36/540 (page 36)
    ends the disease, should an effusion of blood take place, and this is a com- mon termination. The pulse during the first two or three days varies from 00° to 70°, while towards tlie end it becomes much more frequent and very fidl. During the invasion, and after tlie disease is fully established, esi)ecia]ly if the inflammation extends to the base, the head may be drawn backwards and downwards. RamskilP has called attention to the hyper-sensitiveness of the cornea, and I liave been often impressed by another symptom, viz., the redness of the conjunctiva and the constant tendency to lachrymation. Vomiting very commonly takes place, and is always quite a suggestive symptom of meningeal trouble. When tlie disease follows otitis its onset is not so sud- den as when it is the result of injury, but a train of symptoms of gi-adual appearance marks the extension of the morbid process step by step, though in some instances rigor witli sudden coma may be the first indica- tion of mischief. This is in most cases the purulent form. Cases of the idiopathic variety of pachymeningitis are quite rare, although several liave been reported by Abercrombie and other older writers. One case related by the former authority may be worth mentioning. This writer also gives six others which originated from middle ear disease or abscesses in other bony cavities. These latter cases are not uncommon, if we may accept the experience of aurists and surgeons. Abercrombie's' patient, in whom the disease was idiopathic, died in fifteen days. The first indication was severe pain in the left temple, which continued for two weeks, when a swelling appeared beneath the left upper eyelid. Four days before her death violent convulsions took place, whicli were preceded by sliglit rigors. The swelling was punctured, and a considerable quantity of pus escaped. A probe passed into the opening came in contact with bone, and could be inserted for some distance, the end being in contact with the roof of the orbit. During previous days her condition had varied to a great degree, and at times she seemed to be very comfortable. On the day before her death she complained of vertical headache, became semi-comatose, and died in this state. Extensive discoloration, thickening, and otlier changes in the dura mater were found with adventitious membrane and pus. Fizeau' mentions a case which closely resembles this one, and another quoted by Abei-crombie, and seen by Prathernon, was also of idiopathic origin. Aberci'ombie's other cases present common symptoms which were traced to assignable causes. Dr. Clark* has presented five cases of the acute form, due to otitis. Dr. Bauduy* another which followed scarlet fever, and many of the same kind may be found mentioned by other authorities. ' Russell Reynolds' System of Medicine, vol. ii. page 325. * Abercrombie on the Brain, page 21. ^ Journal de M6dccinc, torn, ii., New Series, page 523. '' Transactions New York Rathological Society, 1876. * St. Louis Clinical Record, March, 187G.