The localization of cerebral disease : Gulstonia lectures of the Royal College of Physicians for 1878.
- Ferrier, David, Sir.
- Date:
- 1878
Licence: Public Domain Mark
Credit: The localization of cerebral disease : Gulstonia lectures of the Royal College of Physicians for 1878. Source: Wellcome Collection.
Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)
45/162
![epileptic convulsions) at a distance from medical supervision, and no post-mortem examination of the brain was made; but, through the exertions of Dr. Harlow, the skull was exhumed and preserved. Upon this the exact seat of the lesion can be determined. The line of union of the cicatrices of entrance and exit, however, allowed a pretty accurate estimation of the track of the bar during life, and Dr. Bigelow did so with considerable accuracy. Dr. Bigelow, who examined the man two years after the accident, thus describes the appearances presented: 6 A linear cicatrix of an inch in length occupies the left ramus of the jaw near its angle . . . The eyelid of this side is shut, and the patient unable to open it; the eye considerably more prominent than the other. [Vision lost (Harlow).] ... Upon the head, and covered by the hair, is a large unequal depression and elevation ... A piece of the cranium of about the size of the palm of the hand, its posterior border lying near the coronal suture, its anterior edge low on the fore- head, was raised upon the latter as a hinge, to allow the egress of the bar ; still remains raised and prominent.' From his examination of the skull itself, Dr. Harlow thus de- scribes the track of the bar. 4 The missile entered, as previously stated, immediately anterior and external to the angle of the inferior maxillary bone, proceeding obliquely upwards in the line of its axis, passed under the junction of the superior maxillary and malar bones, comminuting the posterior wall of the antrum, entered the base of the skull at a point the centre of which is an inch and a quarter to the left of the median line, in the junction of the lesser wing of the sphenoid with the orbitar process of the frontal bone—comminuting and removing the entire lesser wing with one half of the greater wing of the sphenoid bone—also fracturing and carrying away a large portion of the orbitar process of the frontal bone, leaving an opening in the base of the cranium, after the natural effects at repair by the deposit of new bone, of one inch in its lateral, by two inches in its antero-posterior, diameters.' (Op. cit., p. 17.) Dr. Harlow does not describe the further track of the bar throusrh the frontal bone, but you will clearly see,, from the figures, that the whole lesion is situated anterior to the coronal suture. If, now, you will compare the track of the bar through the skull](https://iiif.wellcomecollection.org/image/b21271409_0045.jp2/full/800%2C/0/default.jpg)
