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.

    42/540 (page 42)
    iiiUTow vessels, and tha hiyer iioumst tlie anicliiioid, often firmly iniiliiig the arachnoid to the dura mater, is remarkable lor \ery large capilhH ries. The size of the luvniatoma may vary from that of a small bean to that of an orange, and in one ease, tiie autopsy of which was made by Di-. ITnbcr of the Colored Home, the blood-cyst covered one entire side of tlie brain, and was fully an inch in depth. Tiie patient was under tlie care of Dr. Whitall, who kindly contributes the following notes : P. B., GO, widower, N. Y.; mulatto; father, mother, and one brother died of phthisis. The patient has been intemperate, ljut now drinks oidy in moderation. He denies venereal disease; twenty-five years ago he had smallpox, and has since had intermittent fever and cliolera. His trouble dated from an injury seven years ago. He was thrown from a hay-truck to the ground, tailing u])on his head, and causing blood to How from his left ear; but he was able to walk to his home, one mile distant. He seems to have received no very serious injury, if we may judge I'rom the immediate symptoms. Since the fall lie has been troubledwith head- ache off and on, increased by approaching a fire. He cannot appreciate the ticking of a watch pressed to his left ear. About a fortnight ago lie had a chill, fever, and cough, some pain in back, with soreness around the whole gluteal region. Urination Wixs slow, disturbed, and at one time he was unable to pass water; at another it would be too free; has been growing weaker since. June 15, 1874. On admission patient was confined to bed; owing to apparent weakness in lumbar region he was unable to stand. In a few days he began to improve under the administration of iodide of potixsh. Walks with a staggering gait, and cannot follow a straight line. On closure of eyes does not have a tendency to fall. Heavy expression of countenance. No diminution in acuteness of sensibility can be discovered over any portion of the body. Had incontinence of urine on admission; is not so troubled at present time. Can Avalk about the ward; at times can dress without assistance. To-day complains of frontal headache; sleeps very soundly, with stertorous breathing. Appetite good; bowels constipated. 24th. Staggering gait, and inability to walk in a straight line, still pre- sent. If he closes his eyes while standing, there is a tendency (which by an effort he can overcome) to fall backward. Complains of pain on right side of head and face; sleeps most of the day in a chair; at night snores loudly. Bowels constipated. Nocturnal incontinence of urine exists. Feb. 6, 1875. To-day, Avhile patient was sitting in a chair, he had a convulsion, and then became comatose. Urine albuminous. Ordered ol. tiglii TT^iv, after the action of wiiich he appeared much better. loth. Very little change in patient's general condition since above note. Is still apathetic, and complains of pain in head, on right side especially. There is still right facial paralysis, with somewhat di- minished sensibility in this region. The tongue deviates, if any, to the right. Pupils normal in size and reaction. No notable change in hear- ing. No loss of motion, though the riglit arm and leg are weaker than the left. The lower limbs (left more readily tlian rigiit) can be drawn upwards, and extended witli little trouble. He is unable to walk or stand witiiout being supported, as the right leg gives way; complains of con-