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.

    46/540 (page 46)
    ease from tlie tyinpiinic cavity, blows upon iho liead, and sudden cliangcs of temperature of a.ny kind, are tiic direct causes of acute meiiiiirritis. °In one of my cases the disease was the result of a sea-batli. Tlie ])atienf, after batliing, sat for some time with uncovered head upon tlie beach ex- posed to the heat of a noonday sun. Ilaeddeus' reports a case of tliis disease which resulted from typlioid fever. Diagnosis—Acute cerebral meningitis may be mistaken or con- foundctl M'ith cerebritis, typhoid fever, or delirium tremens. Tlie d(di- rium, headache, and disorders of motility are much less marked in cerebritis than in acute meningitis, and it must be remembered that the pulse in the latter disease is much more rapid and full, and the temperature much higher. Typhoid fever is symptomatized by elevation of evening tcinperatiire, diarrhoea, abdominal tenderness and tympanitis, muttering delirium, and the presence of petechias. Delirium tremens may be occasionally con- founded with the disease under discussion, but it must be remembered that the history of alcoholism—peculiar delusions and alcoholic delirium, the absence of headache and the condition of the skin, are all evidences of delirium tremens, which are not to be mistaken. Pathology and Morbid Anatomy—When the pia mater and arachnoid become the seat of inHainnuition, we may roughly group the lesions and consequent symptoms into two classes, one indicative of basal trouble and the other of vertical. In the former, cranial nerve-trunks will be injured or diseased ; while in the latter, the investing membranes of the cerebrum will be the seat of morbid action, and the functions of the cortex must be consequently destroyed, so that the symptoms will be more of a psychical character than when the base is involved. The recent investigations and contributed cases of Landouzy,* of which 104 are presented by this author, demonstrate the connection between cer- tain symptoms and lesions of the description to be hereafter mentioned, in- volving those portions of the cortex containing the centres of Hitzig' and Fritsch. These prove very clearly that violence of the inflammatory pro- cess in certain places may be attended by certain paralyses or contrac- tions of limbs which are innervated from these centres. A case which recently came under my observation is one of this kind, and possesses great pathological interest. E. B., aged thirty-six, born in Ireland, by occupation a blacksmith, is a stout, well-made man of nervous temperament, and up to the commence- ment of his present trouble had enjoyed uninterrupted good health. lie has not had syphilis, and his habits have been good. His mother and father are dead, the former having died of old age and the latter of phthi- sis. There is no family history of insanity, epilepsy, paralysis, nor of any ' Berliner Klin. Wocli. 18C9, p. 564. ^ Contribution k l'6tude dcs Convulsions et Paralysis li6cs aux Meningo-enceph- litis fronto-parietales. Paris, ISTG. Reichert and Du Bois Kcymond's Archives, 1870, Heft 3.