AN ACCOUNT OF YELLOW FEVER, AS IT OCCURRED ON BOARD THE R.M.S. SHIP " LA PLATA," IN THE MONTH OF NOVEMBER, 1852

John Wiblin, Alexander Harvey
1853 The Lancet  
148 tose than he has yet been ; discharge from the ear increased. Mr. Hilton saw him, and desired some of the fluid to be collected, as he considered it to be cerebro-spinal, and the case to be one of fracture of the base of the skull through the petrous portion of the temporal bone, and intersecting the internal auditory canal. Half an ounce was collected in an hour. This fluid corresponded with cerebro-spinal fluid in every respect, except in being a little more coagulable by heat, and
more » ... by heat, and containing a few minute flocculi. -Seven r.M.: Much more comatose ; motions passed in bed; breathing labouring; paralysis and loss of sensation increased. From this time the patient got rapidly worse, and, after a few slight convulsions, he died at half-past one, P.M. Post-mortem examination, sixteen hours after death.-Countenance livid; teeth and hands firmly clenched; the wound of the head is quite healed. Upon removing the calvarium, a small clot of blood was discovered between the dura mater and the skull, just at the anterior and inferior angle of the right parietal bone. The vessels of the dura mater were much congested, as were also those of the brain. Upon removing the brain, and examining its sections, its bloodvessels were found to be much filled with blood, principally upon the right side and anteriorly, where there was also a great quantity of sub-arachnoid purulent effusion. The ventricles of the brain did not con tain more fluid than natural. Upon lifting up the right cerebral hemisphere, a fracture was seen extending from the middle of the right lambdoidal suture, passing directly forwards, and perfectly bisecting the sub-arachnoid and bony canal extending to the foramen auditorium internum. The dura mater itself covering the bone had not been torn. You may now convince yourselves, by examining this preparation, that my description of it is quite correct. We shall proceed with this important subject when we next meet.
doi:10.1016/s0140-6736(02)69099-3 fatcat:qcu3pgnif5erzcaf5fsnbs2n6i