On aphasia, or loss of speech in cerebral disease / by Frederic Bateman, M.D.

  • Frederick Bateman
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: On aphasia, or loss of speech in cerebral disease / by Frederic Bateman, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    loaded witli litliatcs. Tliere is a well-marked double bruit heard nearly all over the anterior part of the chest, but at its maxirauni in- tensity at the apex, the diastolic murmur being the most marked. Pulse 84, quite steady and regular, but very hard, sharp, and almost dicrotic. January ISth.—This patient continued much the same as on ad- mission up to 6 p.m. yesterday, when the nurse, on taking him his tea, noticed he had lost the power of articulation, although he seemed to know all that was going on ; a few minutes before the power of speech was lost he spoke a few words, implying that he saw imaginary beings around his bed. Tiie power of articulation was never recovered, and he soon became comatose, and died early this morning. Autopsy.—Heart: weight 19 oz.; right ventricle contained coloured and decolorised clots extending just beyond the pulmonary valves ; right auriculo-ventricular orifice admitted four fingers and a thumb: tricuspid valves healthy ; walls of left ventricle immensely hyper- trophicd ; dilatation of left auriculo-ventricular orifice; the mitral and aortic valves were both covered with fibrinous vegetations, apparently recent; there was commencing atheroma to the extent of an inch and three quarters at the origin of the aorta. Liver: weight 41bs. 2 oz., healthy. Kidneys : the right weighed 11| oz., the left 8 oz., both in a state of intense con;,restion. Spleen: very soft and friable, contained several fibrinous blocks. Brain : stripped of dura mater, it weighed 31bs. 3^ oz.; there was no abnormal vascularity or other morbid appearance, either on its convex surface or at the base. There n as a general flattening of the superior surface of the right hemisjDhere, which was somewhat less developed than the left, and its convolutions were shrunk. The brain was carefully sliced, and no abnormal ap- pearance disclosed until opening the lateral ventricles, when a yellow stain was seen on the upper portion of the ricrht corpus striatum ; on a level with this body, but behind, and external to it—at about the middle third of the hemisphere—was a softened portion of about the size and shaj^e of a large walnut; there was also slight softening of the thalamus at its jDOsterior part. On cutting into the corpus striatum it was seen that the posterior two-thirds had. undergone the softening process, being of a yellowish hue, and waxy consistency. Antero-posterior slices were made in both anterior lobes, but no mor- bid change revealed ; the frontal convolutions were examined with ^reat care, and the right and left convolutions compared, but they seemed perfectly healthy; but as the softening of the right hemis])hp'-e approached so near the surface of the right side—certainly within half an inch of Broca's region—it is quite possible that some slight altera^ tion of the posterior part of the frontal convolutions may have existed, not patent to our means of investigation. The vertebral and basilar arteries were healthy, as also the termination of the carotids. There was no obstruction of the middle cerebral arteries, but that on the right side, when traced along the fissure of Sylvius, presented at the point of