ST. GEORGE'S HOSPITAL. SYMPTOMS OF DISEASE OF THE BRAIN, THE RESULT OF A CYST FOUND IN THE CEREBELLUM

D FULLER
1861 The Lancet  
No manifestations of cerebral disturbance were noticed in the subject of the following case up to four weeks previous to admission, when giddiness ushered in unmistakable symptoms of disease, which terminated fatally. The autopsy revealed the presence of a cyst in the cerebellum, the period of the formation of which is a question of much pathological interest. Reasoning from analogy, the inference is very strong in favour of the growth of the cyst for some time prior to the occurrence of
more » ... ss :-George S-, aged sixty, was admitted on December 12th, 1850. He was said to have had good health until four weeks before his admisdon, when he began to be frequently giddy. When in the hospital he was odd in his manner, as if insane, frequently asking to be killed, and insisting on shaking hands with all comers. He often got out of bed, and liked to micturate on the floor. His statements were incoherent and contradictory. No disease could be at first made out, and it was contemplated sending him to an asylum. When he had been in the hospital for a few days it was found that he had considerable loss of power in the left limbs, and bichloride of mercury was ordered. (Iodide of potassium, ten grains; liquor of bichloride of mercury, two drachms: three times a day.) This did not cause much alteration. The right eyelid was half shut, but was incapable of quite closing, and the eye itself without vision; the conjunctiva was covered with mucous secretion. Cinchona was now given with iodide of potassium. He gradually became drowsy, and was evidently getting lower. He had wine and ammonia; but he soon became stertorous and comatose, and so expired on Jan. 5th, 1861. Autopsy, eighteen hours after death.-The body much emaciated, with a bed-sore on the right buttock. There was a very large quantity of clear serum in the lateral ventricles, and the convolutions of the brain were somewhat flattened. The septum ventriculorum was entire, but thinned and rather soft. In the left hemisphere of the cerebellum was a large cavity, about equal in size to a walnut, filled with clear serum, and lined by a smooth, shining surface, in which several large vessels were to be seen. There was no trace of the corpus dentatum on this side. The cavity reached nearly as far as the fourth ventricle, but was separated from it by a portion of the medullary tissue of the cerebellum. The vessels at the base of the brain were healthy. There were partial old adhesions on both sides of the chest. All the other viscera were healthy. WESTMINSTER HOSPITAL. of Ilfracombe (p. 239), detailing instances of conservation of the finger (four instances), teeth, and nose, that had been detached. We now add three other cases, forwarded by Mr. Slayter, the late house-surgeon to the Westminster Hospital. The record of these various cases ought to convince surgeons that no chance should be thrown away of trying to save small portions of the body which have become detached. The importance of this practice is well seen by the success which has attended it. A woman came to the hospital in May last, about five o'clock and stated that she had had her nose bitten off by another woman about an hour previously. She brought the piece with her; it was quite black, and covered with dirt. However, Mr. Slayter washed it in warm water, and carefully sewed it on again with silver wire. In a fortnight it was perfectly attached, and had been adjusted with such accuracy that one conltl scarcely tell she had ever lost her nose. A man entered the hospital in March last, and stated that he had had three of his teeth knocked out in a fight. On examining his mouth, it was found that he had lost his three upper incisors, which he brought with him. Mr. Slayter tied them in with silver wire, and in ten days two were quite tight; thet other would not stop in. In April last a man came to the hospital, and showed Mr. Slayter a piece of his own scalp, about the size of a five shilling piece, which he stated had been knocked off by a quart pot in a fight. It was sewn on, and in less than a fortnight it was perfectly united. _____
doi:10.1016/s0140-6736(02)54310-5 fatcat:jtdrouc3nzaibo36mz6vst3jji