Contribution to the study of cerebral surgery based on an operation for the removal of a tumor / by M.H. Richardson and G.L. Walton.
- Richardson, Maurice H. (Maurice Howe), 1851-1912.
- Date:
- 1893
Licence: Public Domain Mark
Credit: Contribution to the study of cerebral surgery based on an operation for the removal of a tumor / by M.H. Richardson and G.L. Walton. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![9 remembrance cannot but serve to temper the zeal both of the neurologist and the surgeon. As an example of the former type of uncertainty in cerebral localiza- tion, we would mention a case occurring in the Massachusetts General Hospital, where an abscess had been opened in the temporal lobe, result- ing from extension of ear disease. A few days later localized spasms suddenly appeared, limited to the hand of the opposite side, and accom- panied by corresponding weakness. Metastatic process was at once diagnosticated, and a new opening was made over the hand centre, with an absolutely negative result, beyond a rather free serous discharge. Post- mortem examination revealed nothing definite beyond the temporal abscess. Such cases detract in no degree from the accuracy of our knowl- edge regarding the hand centre, nor should they deter us from making at least an exploratory excision over the hand area; they do show, how- ever, conclusively, that distant lesions may set up an irritability of motor centres—an element always to be borne in mind when we are tempted to assure the family of success in a given case. Each reported case, successful or unsuccessful, adds something to our stock of knowledge in this by no means exhausted field. The percentage given by the writers above alluded to (The American Journal of the Medical Sciences, vol. cv. No. 252) both of success in finding the tumor and of recovery after removal, is probably larger than it would be if all unsuccessful operations were faithfully reported; but even making due allowance for this probability, we have left a result sufficiently gratifying to mark a most important era in surgery and neurology—by no means less important from the point of view of the patient and the practitioner than of medical science in the abstract, in that it offers at least a hope of relief in one of the most serious of ills to which humanity is subject. The patient whose case we have to report—T. B., of Springfield, aged forty years, married—was under the care of Dr. C. P. Hooker, of that city, who first called Dr. Walton to see the case on February 22, 1892. The history was as follows: He had been subject for some time to occasional attacks of headache of brief duration, and at times found difficulty in expressing himself. At first these attacks occurred only at intervals of two weeks, then of a week, then of only a few days. This was about the frequency when he first consulted Dr. Hooker, about a month ago. The attacks had now increased in intensity and frequency, so that the pain was almost unbearable, and he had had as many as two in an hour. The pain was rather worse at night. A fortnight pre- viously he had seen double, the images being horizontally placed. Of late a red spot had appeared in the field of vision, situated somewhat to the left. There was considerable ])hotophobia—worse on the left. He had had no trouble in understanding what people said, as regards the words, but had lieen unable at times to connect the idea with the word, both spoken and written. For example, he did not realize the meaning](https://iiif.wellcomecollection.org/image/b22379290_0006.jp2/full/800%2C/0/default.jpg)
