A handbook of the theory and practice of medicine / by Frederick T. Roberts.
- Frederick Thomas Roberts
- Date:
- 1873
Licence: Public Domain Mark
Credit: A handbook of the theory and practice of medicine / by Frederick T. Roberts. Source: Wellcome Collection.
966/1060 page 962
![they indicate but little and brief excitement, or none at all, while signs of failure of the cerebral functions speedily set in. The diffuse form is always preceded and accompanied by symptoms of meningitis, and in proportion as these are but little marked and of short duration, and the more rapidly stupor and coma, sensory anaesthesia, convulsions, and paralysis set in, the more probable is it that the brain itself is involved Pyrexia also is not so high. Local inflammation is always very obscure at the outset. 1'iv- quently there is a severe, prolonged rigor at first, which may be repeated on several days with almost regular periodicity. Some- times, without any particular previous symptoms, the patient is seized with an apoplectic or epileptiform seizure, or gradual comaj sets in; occasionally hemiplegia, without loss of consciousm —, has been observed. As a rule, however, there are early symptoms, viz., deep and sometimes fixed headache, often considerable, and of a dull character, but not in violent paroxysms, vertigo, heat of head, restlessness, sleeplessness, a heavy expression, mental confusion, irritability, sometimes talkative, but not violent, de- lirium, dimness of sight, partial deafness, sensations in various parts of the limbs of tingling, numbness, formication, or sense of] deep pain or coldness, general weakness and languoi*, with tremors,! twitchings, rigidity, or paralysis of various muscles. The pupil presents all possible variations. There is comparatively little pyrexia. Vomiting is not infrequent. Sometimes articulation is impaired, or there is a disinclination to speak, or complete aphasia. The subsequent symptoms in fatal cases are stupor, ending in| coma; gradual loss of all sensation; convulsions, hemiplegia, or general paralysis, usually with rigidity or tetanic spasms; and involuntary escape of urine and faeces. Some cases do not end fatally, but permanent disorder of the mental, sensory, or motory functions usually remains. In pyaemia it is rarely possible to diagnose cerebral abscess, and in some instances the symptoms closely resemble low fever. Very exceptionally a collection of pus in the brain bursts externally.](https://iiif.wellcomecollection.org/image/b20402740_0966.jp2/full/800%2C/0/default.jpg)
