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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![of the word “ Blaine ” (word-deafness); and, again, could not tell whether the number 3650 on a box corresponded to 3650 on a shelf (mind-blindness). He kept saying “ barrel of lead ” for “ loaf of bread,” though he knew what he wanted (ataxic aphasia). His previous health was good ; his family history negative. Physical examination showed a large, well-developed man. The pulse was 64, full and soft. The gait was normal; there was no paral- ysis of motion or sensation. The pupils were alike and reacted to light. There was paresis of the abducens oculi on the left. The patient spoke slowly, and occasionally misplaced words, always correcting himself, however. During an attack of pain the pulse dropped to 48. There was homonomous restriction of the field of vision on the right (hemi- anopsia) falling short of the median line. The acuity of vision was unaffected. The fundus showed a haziness which suggested commencing optic neuritis, though the edges of the nerve were distinct and there were no hemorrhages. It was decided best to postpone operation long enough to give specific treatment a full trial, though nothing in the history indicated this etiology. (The event proved that the new growth was not of specific nature). This treatment was faithfully carried out by Dr. Hooker during the next few weeks. Three days after Dr. Walton’s visit he was taking 95 grains of potassium iodide per diem. At this time the left pupil seemed slightly larger than the right, and reacted sluggishly to light. One week later Dr. Hooker wrote: Spkingfield, Marcli ], 1892. Dear Doctor: Concerning B., headache so intense that he requires morphine, gr. J, with atropine, gr. every morning and night. Before use of morphine the pain was constant and severe, with half-hourly exacer- bations. At this time, pulse 40 and skin bathed in sweat. Pain localized more in left occipital region, near median line, just above protuberance. Ataxic aphasia much more marked; hardly utters a sentence without mis- pronouncing one or more words or substituting some word which sometimes makes sense, more often does not. Difficult to understand him. Appetite indifferent. Vomits three or four times a day—no connection with taking food. The vomiting seems more like regurgitation, and is often copious—for example, half a chamberpotful. No paralysis except of sixth. Diplopia marked to-day. Think his mind is a trifle cloudy. Potassium iodide, gr. 110, to-day. I do not think potassium iodide has anything to do with his symptoms. Thought possibly morphine might make him a trifle dull. The nausea is not such as we see with morphine. Will write again this week and give you result of ophthalmoscopic examination. Yours in haste, C. P. Hooker. Three days later he wrote as follows: SPRINGFIELD, March 4, 1892. Dear Doctor : Yours of the 3d received. Dr. Morgan examined B.’s eyes yesterday—finding double optic neuritis. The nerve is not visible in either eye and is swollen fully D. There are multiple hemorrhages. The pain is more occipital than ever. All the symptoms seem more intensified. He is weaker and confined to his bed. Night before last I made a minute of some of his errors of speech. Notice the fact that in nearly every one the letter L is either omitted or unnece-ssarily put in : Olood for gruel; hleefxteak ior beefsteak; expain for explain; mate for late\ sweeping iox sleeping; speak for sleep. He attempted to say first-rate, said first-nete, noticed his error and in attempting to correct it said first-nice—this seemed to satisfy him. Mrs.](https://iiif.wellcomecollection.org/image/b22379290_0007.jp2/full/800%2C/0/default.jpg)
