Indications for operation in disease of the internal organs / Authorized English translation by Keith W. Monsarrat.

  • Schlesinger, Hermann, 1866-1934.
Date:
1906
Catalogue details

Licence: Public Domain Mark

Credit: Indications for operation in disease of the internal organs / Authorized English translation by Keith W. Monsarrat. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    29/522 (page 9)
    was suspected, irregular fever was present for some weeks. At the autopsy a diffuse glioma infiltrating the convolutions of the right frontal lobe was discovered. A most careful examination, carried out by Prof. Weichselbaum, failed to reveal any other lesion to account for the fever. More rarely there arises a difficulty in differentiating between tumour and sinus thrombosis (q.v.). Oppenheim has rightly remarked that the differential diagnosis between tumour and acquired hydrocephalus can hardly ever be made with certainty, especially as the latter affection very often complicates tumour. He has enunciated the following points in favour of hydrocephalus : the characteristic hydrocephalic shape of the skull, a duration of several years, and the absence of well-marked focal symptoms. Of greater practical importance is the probability of confusion with general paralysis, especially when the latter exhibits in its early stages the characters of cortical epilepsy. Optic neuritis will exclude general paralysis, and complete reflex immobility of the pupil is rarely present except in cases of tumour. In the late stages of tumour, and especially of multiple tumours, the symptoms may closely resemble those of general paralysis. I have seen a case of cerebral tumour, operated on with good result, which had been diagnosed as general paralysis by several distinguished physicians. The examination of the fundus oculi revealed the presence of optic neuritis, and this led to a correct diagnosis. When a tumour is associated with convulsions at an early stage, a differential diagnosis from ordinary epilepsy has to be made ; the presence of other symptoms will facilitate this, in particular optic neuritis, which is not found in ordinary epilepsy. The phenomena of Jacksonian epilepsy which is not caused by tumour (e.g., that due to softening or scar formation), do not show, as a rule, the tendency to progression which is found in tumour. Uraemia may give rise to symptoms resembling those of cerebral growth. Headache, vomiting, slowness of pulse occur in the course of both affections, and renal disease may give rise to optic neuritis, with swelling of the disc. On the other hand, a brain tumour may cause albuminuria. The presence of renal epithelium in the urine will always point