The first lines of the theory and practice of surgery: including the principal operations (Volume 2).

  • Samuel Cooper
Date:
1844
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Licence: Public Domain Mark

Credit: The first lines of the theory and practice of surgery: including the principal operations (Volume 2). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    under twenty-one years of age. This shows, that we have a greater tendency to fungus cerebri in young subjects. In twenty-one of the cases, the dura mater was lacerated, in ten there was no solution of its continuity. In fourteen, the brain was wounded, and portions torn away, in five, it was wounded, but none torn away, and in ten, it was not seen, as the dura mater was whole. The time when the fungus commenced varied. In six cases, it oc- curred before the sixth day ; in fifteen, between the seventh and twelfth ; and in five, between the twelfth and twenty-fifth days, and in one instance, after eight weeks. The earliest appearance of the disease was on the third day, and more than three-fourths of the hernia, occurred before the twelfth day. Seventeen recovered, and sixteen died. Twelve of those who recovered were twelve years old and under, and only five of those who died were less than twelve. The size of the tumor varied, from one inch and a half in diameter, to a mass measuring six inches by three and a half on the surface, and two and a half in thickness. The tumors, in eleven of the six- teen fatal cases were examined ; nine of them, were composed of the medullary and cortical substance of the brain and two of those reported by Mr. Abernethy, consisted of a coagulum of blood. From this analysis of Dr. Buck we learn, thai young subjects are more exposed to fungus cerebri than old, probably because there is al- wajs a stronger tendency to inflammation of the brain in children. We learn also that there is more danger of hernia, when the dura ma- ter is lacerated, and the brain wounded. We discover too, that the tumor shews itself, generally, by the twelfth day, after the injury ; that when the disease does occur, there is an even chance that the patient will recover; and that the younger the subject, the better the prog- nosis. We learn, moreover, that the structure of the tumor is cerebral in most instances, and that there is no one course of local treatment, which can be relied upon in all cases. We entertain the opinion, that the liability to the occurrence of hernia, is always proportionate to the amount of general injury of the brain. We have never yet seen a case of fungus cerebri, however extensively the dura mater and brain were lacerated, except when there had been decided concussion.—Ed] FUNGOUS TUMORS OF THE DURA MATER. Fungous tumors sometimes grow from the external surface of the dura mater, and, after destroying the superincumbent portion of the cranium, make their appearance in the form of an external swelling under the scalp. They are generally preceded by a blow, or fall on the head, and occur at the part to which the violence was applied. As the fungus grows larger, its pressure against the skull, and par- ticularly its pulsatory motion derived from that of the brain, occa- sion a slow and gradual absorption of the bone, just in the same