Ophthalmology and diseases of the nervous system, being : the Bowman Lecture, delivered Friday, November 13th, 1885 / by J.Hughlings Jackson.

  • Jackson, J. Hughlings (John Hughlings), 1835-1911.
Date:
[1885?]
Catalogue details

Licence: Public Domain Mark

Credit: Ophthalmology and diseases of the nervous system, being : the Bowman Lecture, delivered Friday, November 13th, 1885 / by J.Hughlings Jackson. 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 epilepsy so complicated is most desirable. A man had occasionally smells in his nose heralding in slight attacks of epilepsy with the dreamy state there were left-sided “ shakings in the paroxysms. There was double optic neuritis, but no defect of sight; the neuritis passed off under mercurial inunction and iodides, sight remaining good. The patient died apoplectic with left hemiplegia ; his case illustrates the dictum that a man with optic neuritis is to he considered as being in imminent danger of death ; that this patient was in any such danger no one would have surmised who did not find out that there was optic neuritis. Whilst the optic neuritis is the best indication for treatment, and of most prognostic value, such an important variety of epilepsy as this patient had deserves most careful investigation. In this’ association the lecturer urged that the great thing in the diagnosis of epilepsy is not so much the “ quantity or severity of the symptoms’’ as their paroxysmalness, and that the slighter a paroxysm, the more necessary, both for the patient’s sake and for medical science, is its minute investi- gation ; attacks of epilepsy with the ” dreamy state,” when very slight, as they often are, are sometimes attri- buted to hysteria or to stomach and liver derangement. To the uninstructed the accounts given by the patients seem “ fanciful.” That optic neuritis is often overlooked in its prasmaurotic, most curable, stage is certain. The case mentioned was the only case of epilepsy with “ dreamy state ” the lecturer had seen complicated with optic neuritis; there was no necropsy ; the presumption is that death occurred by hasmorrhage from a vascular tumour in the right cerebral hemisphere. Another case of this kind of epilepsy (bitter taste, ''dreamy state,” and right-sided numbness), investigated by Dr. James Anderson, was com- plicated by simple atrophy of the optic nerves ; there was loss of sight of the left eye, of the right field of the right eye, almost loss of smell on the left side ; defect of taste, more on the left side. (The paroxysmal one-sided sym- ptom (numbness) was right-sided, and the patient was