Case of ab[s]cess of the brain / by J.W. Begbie.

  • Begbie James Warburton, 1826-1876.
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: Case of ab[s]cess of the brain / by J.W. Begbie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    communication with the ventricle. On exposing the latter, it appeared remarkably dry, and its cavity diminished. The interior of the abscess was, at points, lined by a pale, thin, false membrane ; at others, the pus lay in contact with the cerebral substance, which there appeared softened ; other- wise it was firm, and not unhealthy-looking. The lining membrane could with ease be separated and i-emoved. At the anterior and inner aspect of the cavity there existed a fistulous opening, through which the pus easily passed. The cribriform plate of the ethmoid bone was, on the left side of the crista galli, blackened and necrosed; on the right side it was also affected, but evidently to a less degree. The crista galli retained its usual shape, but was black and rough. Over the cribriform plate of the left side there was the debris of necrosed bone, mixed with thick purulent matter; and, on passing the probe through it into the lateral mass, it easily crumbled, and the instrument passed into the nose. On the interior of the frontal bone there were a few spiculse of rough bone. The interior of the skull pre- sented no other traces of disease, and we could not detect any evidence of a previous fracture. The left orbital plate was thin, as compared with the right. The little abscess described in the case as situated near the inner canthus of the left eye, did not appear to have any connexion with dis- ease of bone. I wished to have been able to render the examination more minute, but the manner in which our operations were watched, and the promise we had come under, rendered that impossible. Remarks.—The case just related appears to me interesting on many accounts. The post-mortem appearances, when attentively considered, render very improbable the idea that the abscess of the brain was of recent formation, while the whole history of the case leads me to the opinion, that the sufhciently severe injury of the head, sustained nearly five years before death, was its origin; that, dating from that, there arose a slow inflammation and gradual softening of a portion of the cerebral substance, terminating in suppura- tion and in the formation of an encysted abscess. Further, that probably arising from the severe and continued labour which my patient underwent on his return to Edinburgh,