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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    usual labour. This occurred about a week ago, and since that time the complaint has been nearly stationary. He can walk with a dragging and imperfect motion of the right leg, but has very little use of his arm; he has still pain along the upper part of the head ; the numbness of his cheek is gone, and his speech has never been affected. This course of symptoms constitutes a case remarkably different from the attack of the apoplectic hemiplegia, which is generally sudden and complete. Whether the difference depends upon such a difference in the cause as I here suppose, I do not determine, but rather, at present, propose it as an interesting subject for observation. I think it is rendered probable by many of the facts which I have men- tioned, both in this paper, and in my former paper on Chronic Inflammation of the Brain. I do not, however, mean to say that every case of inflammatory paralysis is distinguished by this particular progress of the symptoms. On the contrary, in some cases that are ascertained to be of this nature, the attack seems to be as rapid as in the apoplectic paralysis; and we naturally expect such differences in the inflammatory cases, depending probably on the extent of the disease in the brain, which in one case may affect at once a large portion of it, and in another may begin in a very small poition, and extend gradually. It appears, however, from several of the cases which I have men- tioned, that disease of this kind, of no great extent, may be con- nected with extensive paralysis. 1 have already alluded to those cases in which the paralytic attack is preceded or accom- panied by convulsion. These will probably be found to be of the inflammatory kind, especially when the convulsion has been confined to one side of the body, or to one limb, paralysis of the part immediately succeeding it. A remarkable example of this has been described in my former paper. (Case 7.) A most important circumstance in the history of the inflam- matory paralysis is, that all the symptoms may take place while the disease in the brain is in the state of simple inflam- mation, and that it may not have advanced beyond that state while they go through the usual course, and terminate in fa- tal apoplexy. I l.atcly saw a young woman, who, after being for some time affected with symptoms indicating a tendency, to disease in the brain, was found one morning to have lost her speech. She then gradually sunk into coma, with paralysis of the right side, and died on the ninth day. The only morbid . ap])earance was a part of the brain, the size of a large walnut, in a state of high inflammation ; it was at the upper and inner part of tlie left hemisphere, in contact with the longitudinal sinus. '1 here was no cfiiision, and no other morbid appearance, ex-