On amaurosis, accompanied by pains in the head, two years' duration : convulsions, three months : examination p.-m., cyst in the cerebellum / by James Reid.

  • Reid, James, 1803-1854.
Date:
[1851]
Catalogue details

Licence: Public Domain Mark

Credit: On amaurosis, accompanied by pains in the head, two years' duration : convulsions, three months : examination p.-m., cyst in the cerebellum / by James Reid. 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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    portion of its retina. The pain in his head increased as he became blind; it was most severe posteriorly, but pangs were felt through the entire head, pass- ing towards the forehead; it was not constant, being accompanied by irregular intervals of ease, which lasted sometimes more than a day, when be would join his companions in play. He was much troubled by strange sounds and noises in his head. His intellect remained good, but his temper was much altered; he became sullen and reserved, aud was very irritable. His movements were quick and sudden, but there was no peculiaidty or unsteadiness in them; latterly, he became weak and emaciated, aud his power of movement was affected in consequence. He always sat in one corner of the fire-place wiih one hand supporting the back part of his head, , whilst the other occasionally rested on the forehead. In this position he would remain for the whole or greater part of a day, impatient of every disturbance, but not complaining; now and then by an acute remark showing that he noticed what was going on, though apparently observing nothing. Eleven weeks before his death, whilst sitting in his usual position, he was suddenly attacked by a convulsive tremor of his whole frame, accompanied by a partial loss of consciousness. After this, fits occurred at iiTegular intervals; be would remain free fi'om them for one, two, or more days to gether, and then during one day he would have a rapid succession of at- tacks ; or, during two or three following days, several seizures would take place. The attacks were of an irregularly con- vulsive character, in a few respects i-e- sembling epilepsy, but in others the spasmodic fits of severe hysteria. They commenced with severe pain in the head, passing from the occiput to the fore- head ; the boy would put his two hands in these situations, uttering in rapid succession the exclamation, “ Oh, ray head! until apparently overpowered by the pain, and the spasmodic movements which followed. Consciousness did not, at this period, seem entirely gone ; for if touched by a hand he would violently catch it, and draw it upwards by a con- vulsive grasp, from which it was with difficulty extricated. The spasms were principally noticed in the muscles of the face, extremities, and body; those of respiration were not apparently af- fected ; there was no premonitory scream or expiratory sound, no foaming at the moutli, nor stertor. As tlie attack passed off, a very copious perspiration would burst out over the head, face, and neck, continuing for some time, and saturating the ])illow. A heavy, drowsy state succeeded, from which, sometimes, he could not be roused for the remainder of the day, and often, when there had been a succession of fits, for the greater part of the following day. When this drowsy condition ceased, during a variable period he would i-emain curled up in his bed sul- len and iiTitable, with the saliva dribbling from bis open mouth. After tliese fits had occurred for a few weeks, vomit- ing of an obstinate character took place; mucus mi.\ed with bile was generally ejected. The boy became tliin and weak, and was almost confined to his bed, though still, when a temporary cessation of symptoms allowed him, he would crawl down to his accustomed jfiace by the fire. He died January 26th, 1851, sinking quietly a short time after a paroxysm of pain. Examination 27 hours after death.— The body was rigid. The head alone was examined. The scalp was readily separated from the skull. The bones of the head included in the section of the skull were remarkably thin, and were marked over the whole interior with depressions and ridges which re- sembled a model of the convolutions of the brain; some of these fossa;, near the middle, were ascertained to coiTespond exactly with the convolutions. The bone was so thin at the bottom of some of the grooves as readily to allow the transmission of light. The membranes of the brain were natural; its convolutions on the supe- rior and posterior surface were slightly flattened; both its grey and white struc- ture were remarkably firm. The ven- tricles contained about six ounces of clear fluid; there was no undue vascu- larity; and their surfaces, together with the septum Incidum, were firm. All the central organs of the brain were ex- plored, but no traces of disease were found. The optic nerves in their whole course within the cranium were natural. The ethmoid and sphenoid bones ap peared healthy. Between the lobes of the cerebellum, and projecting slightly in the superior