Researches on the pathology of the brain. Part II. On Apoplexy / by John Abercrombie.

Date:
[1818]
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Licence: Public Domain Mark

Credit: Researches on the pathology of the brain. Part II. On Apoplexy / by John Abercrombie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    came comatose, and in three hours more died. The face had still been pale, and the pulse natural. I did not see this patient during her life, but was present at the ex- amination of the body. In the substance of the anterior lobe of the right hemisphere of the brain, there was a cavity filled by a coagulum of blood the size of a hen’s egg. From this cavity a lacerated opeu- ino- led into the right ventricle, and all the ventricles were completely filTed by coagulated blood. A thin stratum of blood was also found under the base of the brain. This blood seemed to have escaped from the ventricles by forcing a passage under the posterior pillars of the fornix. Around the cavity in the right hemisphere, the substance of the brain was broken down, soft and pulpy, almost purulent. Both kidneys were unusually vascular. About the right kidney there was a remarkable turgescence of veins, and an appearance of extravasated blood in the cellular membrane behind it. Sect. III.—Cases of the third class. Case XIX.— D. A. aged 58, a very stout man, of a florid com- plexion, formerly a serjeant, on the 7th March 1817, about nine o’clock in the morning, without any previous complaint, was ob- served to have lost his speech. I saw him about half-past ten, and found him w'alking about his room. He had the full use of all his limbs, understood all that was said of him, and answered by signs, but could not articulate a word ; could put out his tongue freely ; did not admit that he felt any uneasiness in his head ; pulse natural, and of good strength ; face flushed. Repeated bleeding, purgatives, &c. were employed, without producing any change in the symptoms. 8th.—Was found in the morning to be affected with perfect hemi- plegia of the right side ; tongue when put out was turned to the right side; no other change; still quite intelligent ; no attempt at speech. He now lay for about a month without any change in the symp- toms; slept well in the night; in the day was quite intelligent, and answered by signs. For some time, his tongue, w hen put out, was turned to the right side, but afterwards it became straight, lie took his food, and appeared to have no pain ; his pulse was natural. 'I'lic right side continued completely paralytic, and he made no attempt at sj)eech. About the 10th of May, he began to have violent j)ain in the paralytic limbs, and could not bear them to be moved in the gen- tlest way without screaming. Mothing was to be seen about them that could account for the pain. For about a fortnight, he now suffered constant ])ain ; his strength sunk ; he lost his appetite. He then had some vomiting, but not urgent; his pulse became feeble, and his features collapsed, and he died in the end of May, of gradual sinking, without coma. There had been no recovery of speech, or of the nurtion of the right side. Dissection.—On opening the head, there appeared a remarkable depression on the upper surface of the left hemisphere of the brain,