Thirty-second annual report of the Government Hospital for the Insane to the Secretary of the Interior. 1887.

  • Government Hospital for the Insane (U.S.)
Date:
[1887]
Catalogue details

Licence: Public Domain Mark

Credit: Thirty-second annual report of the Government Hospital for the Insane to the Secretary of the Interior. 1887. Source: Wellcome Collection.

    85/92 page 19
    Case 25. T. J. L.; ret. 50 ; marine engineer; nativity, United Spates. This case was obscure. The mental symptoms were mild dementia, and the physical paralytic, but not characteristic. Autopsy.—Autopsy six hours after death. Body well nourished; contractures of lower extremities. Cranium : Antero-posterior diameter, 7J inches; transverse, 5| inches. Dura mater showed early pachymeningitis interna. Brain : Weight, 43J ounces. The pia mater was opaque and thick¬ ened, and adherent to the dura at the vertex, but not adherent to the cortex. On section a large area of softening was found in the right hemisphere, involving the anterior portions of the lenticular and caudate nuclei and the internal capsule. In the left hemisphere a small spot of softening was found in the optic thalamus near the wall of the third ventricle. The puncta cruenta were prominent and the consistence of the brain diminished. Convolutions shrunken. Lungs: Pleuritic adhesions on right side; lungs hypostatic and hem¬ orrhagic. Heart: Spot of recent endocarditis near apex of left ventricle; slight valvular thickening. Kidneys show slight interstitial change. Spleen: Capsule adherent to surrounding parts. Liver: Tissue normal; recent inflammation of capsule. Stomach congested. Acute peritonitis. Microscopical examination.--The vessels did not show any increase of cells in their walls or perivascular spaces. Some of the nerve cells were very granular, and a number were yel¬ low. In the medulla a few cells were seen pigmented with greenish yellow granules. Case 26. M. It.; ret. 45; colored; hostler; nativity, United States. The dis¬ ease was well advanced when admitted. The mental symptoms were profound dementia, the physical were characteristic. Autopsy.—Autopsy six hours after death. Body well nourished. Cranium : Antero-posterior diameter, 7-g- inches; transverse,5| inches. Skull, dense ; diploe present; small veins of inner table prominent. In the falx cerebri were several small irregular pieces of bone. Brain: Weight, 43J ounces. The pia arachnoid opaque over the widest sulci, and the arachnoid at the base thickened over the sub- arachnoidean spaces. The membranes were not adherent to the cortex. The convolutions were atrophied over the auterior and middle regions of the convexity, and in the shrunken regions the consistence was firmer than normal. The ventricles were dilated and their lining faintly granular. The cortex was thinned in the atrophied regions. Arteries at the base atheromatous and their caliber reduced. Lungs : Show bronchitis and some solidification in limited areas. Heart: Slight valvular disease. Kidneys appeared swollen. Spleen and liver normal. Microscopical examination.—The vessel walls were infiltrated with nuclei, and some free cells were seen in the perivascular spaces. Some of the small vessels were very tortuous and were cut in many directions
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