Medical diagnosis : with special reference to practical medicine. A guide to the knowledge and discrimination of diseases / By J. M. Da Costa ... Illustrated with engravings on wood.

  • Da Costa, J. M. (Jacob Mendes), 1833-1900.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Medical diagnosis : with special reference to practical medicine. A guide to the knowledge and discrimination of diseases / By J. M. Da Costa ... Illustrated with engravings on wood. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    or of the abdominal viscera,—and by noting that, ahhough the patient suffers from dull headache, from jerking of the muscles, from pulsation of the carotids, from vertigo, these signs are far from being constant, and come and go for a long time without any material disturbance of the functions of the brain being per- ceptible, in reference either to thought or to voluntary motion. The finding of optic neuritis, or choked disk, would settle any doubt against congestion. Cerebral anxmia, occurring suddenly, produces unconsciousness, or dizziness or stupor; or, if very general, and especially if asso- ciated with venous congestion, it may cause convulsions. When more gradually induced, it manifests itself by drowsiness, distress- ing headache, often more particularly referred to the vertex; by the pale face and uninjected eye with large pupil; by derange- ment of the special senses; by the vertigo and the other symptoms of cerebral disorder being relieved in the recumbent position; and by the feeble pulse and cool forehead. Then in tracing its histoiy we are apt to find that it occurs in those who have been exhausted by debilitating diseases, or by repeated hemorrhages, or by albu- minuria. The chief distinction from softening lies in the history of the case; the aspect of the patient, too, and the absence of palsies, or their passing nature, must be taken into account. But we must not forget that if the morbid condition be long continued, the ill-nourished brain will soften. Abscess of the brain differs mainly in this from chronic soften- ing : the disease is of short duration. Some cases may run a very rapid course, others may continue for months; yet few, as Lebert * has informed us, last longer than eight weeks. Further, we find in abscess, unlike what happens in softening, convulsions in the earlier period, and paralysis late in the malady; and not unfre- quently we discovei, in analyzing the history, that chills have occurred, or we can detect the clue to the cerebral abscess in a disease of the internal ear, or in an injury to the head, or in the presence of suppuration in some distant part of the body. In the early stages abscess is often latent; in the late stages the signs of oedema of the brain, delirium, great depression, decided headache, * Archiv ftir Path. Anat., Bd. x. See also Gull's paper in Guy's Hospital Reports, 3d Series, vol. iii.