On the chemical pathology of the brain / by Adam Addison.

  • Addison, Adam.
Date:
[1866]
Catalogue details

Licence: Public Domain Mark

Credit: On the chemical pathology of the brain / by Adam Addison. Source: Wellcome Collection.

    18/24 (page 18)
    The most striking peculiarity of this case is the small quantity of fat in the medulla, which is so unusual that it may be regarded as pathological. The relation of the phosphorus to the fat is £’31 per cent. VIII.—Kobert McD—, set. 29. Three months resident in the asylum. During that time it was observed that he was very irritable in his temper, and continually made mistakes as to the identity of persons; occasionally he was excited, and talked incoherently. Habits dirty; paralysed on the left side, and on several occasions he had epileptiform attacks, during which the convulsions were con¬ fined to the paralysed side. The paroxysm did not last more than five minutes, and was not followed by coma. It was stated that, before admission, he had been very violent and unmanageable for six weeks, and that for three years previously he had suffered from diabetes insipidus (which, however, did not exist during his resi¬ dence in the asylum); that he was greatly troubled with frontal headache, and that these paroxysms of pain alternated with the diabetes; that is to say, that when he suffered from his head the quantity of urine was not abnormally great, and vice versa. He died suddenly while sitting in his seat. Autopsy.—On cutting through the scalp the temporal muscles of the right side were found to be oedematous. The dura mater was adherent to the calvaria, on the right side, but not on the left. It was also redder on the right than on the left side. On attempting to remove the dura mater, it was found adherent over the anterior lobe of the right side, and on breaking up this adhesion a small quantity of fluid, of the colour and consistence of pus, escaped. The arachnoidal surface of the dura mater was much thickened, congested over the middle and posterior lobes, and over the anterior lobe there adhered to it a portion of the superior surface of the hemisphere, of a rich yellow pus colour. The superior surfaces of both hemispheres were flattened. The left ventricle was opened, and two ounces of clear fluid removed, the whole superior surface of the right anterior lobe was of a yellow pus colour, and in cutting into it, it was found to be quite hard and solid, the hardness extending into the white matter. The extreme anterior point of the lobe was softened, and was removed piece by piece. The base of the brain, the corpus striatum, and optic thalamus, were much softer on the right than on the leftside. The right hemisphere weighed 22 oz.; the left, 18i. A portion of the altered structure placed under the microscope presented cells of various sizes, some round, some oblong, and some angular, filled with granular matter, some being very similar to com¬ pound granular corpuscles, but surrounded by a cell-wall. While parts of the altered brain-substance were abnormally hard, others were undergoing softening. It was regarded as a case of cancer cerebri.