48

Foreign Department.

. In our last number we gavean interesting’ case of cancer ofthe spinal marrow that had beenpresented to the Royal Acade-my of Medicine at Paris, toge-ther with some remarks on it byM. BAYLE, whose zeal in the

pursuit of morbid anatomy mustbe familiar to all who have paidany attention to the labours of

the French in this branch of me-

dical science. The object of

this distinguished pathologist inthe case to which we allude,and the two following, is to

illustrate some points connectedwith the pathology and phy-siology of the nervous system.

Cancer of the Brain.OCT. 29.-Epileptic attacks preceded

by delirium, without pain or paralysisof any part ; six years after recurrenceof the complaint, succeeded by mentalderangement, remission during a year ;then attacks frequently repeated; apo-plectic state, and death. Two scirrhoustumours on the anterior part of thehemispheres of the brain.

Madamoiselle J. æt. 29 yearsof a delicate and irritable con-

stitution ; belonged to a healthyfamily, and had always enjoyeda good state of health. Shewas educated with considerablecare, and for some time past haddevoted herself to the instruc-tion of young ladies, when shewas seized in 1817 with epilep-tic attacks. These attacks,which were rather rare in theiroccurrence, but generally pre-

ceded by delirium, and occa-sionally very violent agitation,consisted in a sudden loss of thesenses, accompanied by convul-sive motions in all the limbs,which were succeeded, after thelapse of a minute or two by thereturn of sensation and volun-

tary motion and a kind of stupor,which soon left her.

.

Towards the end of 1821, theentrance of some thieves intothe house where she lived,gave her a considerable shock.In a fortnight’s time, the at-tacks returned as often as tentimes a day, followed by pa-roxysms of madness. Agitation,loquacity, incoherence in theideas hallucinationsrelative to re-

ligious concerns and severe painsin the head were the most pro-minent features of her conditionat this period ; in eight days shebecame composed, and her rea-son returned.A short time after she was

placed in a lunatic asylum,where she remained more thantwelve months, without expe-I riencing any attacks, or pain inthe head, or the slightest symp-tom of mental alienation. Shethen soon returned to her for-mer pursuits.

But this young lady had

scarcely been at home a month,when the attention she was

obliged to give to her regularoccupations, and probably someunpleasant domestic dccar-rences, produced a return ofthe epileptic attacks, whichwere soon followed by deli-rium. ’Re-admitted in 1823,into a lunatic asylum, she con-tinued there for several monthsjust in the same state. Shespoke without ceasing, and very

49

incoherently, principally on

religious subjects; she didnot enjoy a moment’s repose,and was frequently obliged tobe confined with a straightwaistcoat, but she had no epilep-tic attacks. In a short time herhealth and senses were restored,in fact there was no local de-

rangement ’whatever. Thisstate, however, was of shortduration. The attacks of ’epi-lepsy soon returned, followed byextremely violent paroxysms ofmadness; the maniacal symptomshad considerably diminished to-wards the end of the year, whenthe patient was seized withfresh attacks, which occurredseveral times in the same day.

All the means employed wereunavailing. She soon fell intoan aoonlectic state, and died.

.

On opening the body, twotumours were found nearly ofthe thickness of an egg, situatedon the anterior part of the hemis-pheres of the brain.

Reflections.The case which has just been

detailed is worthy of observa-tion, because it presents us witha very serious injury of thehemispheres of the brain, with-out any of those symptoms whichusually attend this complaint.We know, indeed, that the can-cer of the brain always occa-sions a pain in the head, moreor less severe, and intermit-ting, and at some period ofthe disease hemiplegia su-

pervenes ; to these symptoms,which constitute the true cha-racter of the disease, are added,it is true, attacks of epilepsy,and derangement of the faculties.

In the above case there wereobserved at no period of the

complaint, either alt enfeebledstate of the locomotory powers,or paralysis of any kind. Theepilepsy with which the patientwas attacked, and which itwould be difficult to attribute to

any other cause than the cancercerebri, did not present any dif-ference from common epilepsywhich in general is not accom-paried by any apparent lesion ofthe brain. The paroxysm ofmadness which followed the at-tacks would of themselves havebeen sufficient to withdraw theattention from the idea of cancerof the brain ; for this complaintis not in general attended by thissymptom: Thus the foregoingcase shews, that under certaincircumstances, it is impossible toform a diagnosis of the exist :ence of cancer of the brain. Ina physiological point of view, itis curious to see two large tu-mours pressing on the hemis-pheres of the brain without pro-ducing any permanent disturb-ance of sensation,motion, or theintellectual faculties.

Cancer of the Cerebellum.Æt 33 years ; an occasional lancinat-

ing pain for several years at the pos-terior inferior part of the right side ofthe cranium; attacks more or less re-peated of vertigo with loss of recollec-tion and slight mental aberration ;then feeble state of the mind and loco.motory powers ; no hemiplegia; sud-den death. Lateral Ventricles dis-tended with serum; encephaloid tumourin the right hemisphere of the cerebel-lum.

FRANCIS CLIQUET, thirty-three years of age, of a sangui-neous bilious temperament, andstrong constitution was admittedinto the hospital NECKER, Dec.21st, 1823. He had suffered, attimes, for several years past, adull pain; sometimes, however,

50

acute, at the posterior inferiorpart of the right side of the chest.At no period of his life had hereceived a blow on ’the head.- In the course of June 1823,whilst carrying rather a heavyload, he was seized with daz-zling before the eyes and vertigo,which continued for a quarterof an hour without -the loss ofhis- senses. These symptomshaving increased in severityduring the last month, he ap-plied to the hospital for assis-tance. The patient had not un-dergone any kind of treatment,excepting that at one time adozen leeches were applied tothe nape of the neck, from whichhe. did not derive any markedrelief. The following’ are thesymptoms which presentedthemselves on his admission :countenance pale, knitting- ofthe eye-brows, features con-

stantly expanded by a stupidsmile, particularly when any

enquiry was put to the -patientrespecting his state. Walksimilar to that of a person ine-briated. Nea:rly total loss ofwords, excepting those whichrelated to his own occupation,which was that of a cook’Pulse, appetite, secretions, &c.iiatural.The patient declared that he

had never contratedanyvenerealcomplaint) and that he had notbeen addicted to excesses of anykind: Nothing’ particular wasordered for him, as the medicalattendants were ’anxious beforeany plan of treatment was laiddown; to see the patient in one-of his attacks.December 22, 23,’and 24, in

the same state. Dec. 25. In the

morning the pupils were slightly

dilated ; the other symptomswere the same. In the eveningthe patient was extremely .quiet ; he only answered bymonosyllables, questions whichwere put to him, and did notappear to be, in any pain. Con-tinued in the same state duringthe night. Expired suddenlyon the 26th, at half-past: sevenin the morning’, without convul-sions or even any apparent al-teration of his countenance.

Inspectio cadaverts.The principal appearances

were observed in the brain and-cerebellum, the other parts presented no marked change.

Brain.On lifting the calvarium there

escaped from the sinusses a gooddeal of dark Quid blood: injec--tion of the vessels under thearachnoid ; folds of the brainflattened, substance. of the cere-brtira dense and firmer thanusual ; lateral, and middle ven-tricles enormously distended bya limpid colourless serum, thequantity being* about two glassfulls. The brain was so firmthat when the- ventricles hadbeen emptied the parietes werenot depressed, and the wholeextent of the cavity could beeasily seen.,

Cerebellum.Softer in proportion than the

cerebrum, , but appearing to beabout . the usuaL firmness; inmaking a perpendicular sectionof the right hemisphere, theblade of the scalpelstruckagainsta body harder than the med11Uarypulp, crackling when cut info,particularly in the centre, of thethickness of a moderate -nut, butaltogether of a very irregularform. It occupied the centre of

51

the hemisphere, rather inclinedto its inferior part. Its consist-ance was not the same through-out ; thus in the centre it wasrather hard and crackling underthe scalpel, whilst it becameless solid as it approached thecircumference. The colour wasslightly white, grey, and blue.No traces of fibres’ were to beseen throughout its structazre,but a collection of small grainssimilar to those of snow whenreduced into a mass. All thesoftened points wer surroundedby a viscid tenacious substance,especially towards the lowerpart of the tumour; which inthis direction was divided intothree small lobes, and were at-tached to three small tumoursby a narrow peduncle.

Experiments on MenstrualBlood. Dr. Francesco Lavagnanephew of’ the distinguishedphysician who first recommend--ed the use of injections of am-monia* up the vagina in amen-orrhcea. has been making someexperiments on the blood se-

creted from the uterus duringmenstruation, and which hestates to differ from other blood

only in its possessing little or nofibrine.

Belladonna, as a Preventive of’

Scarlatina.The Archives Generales oflast month contains a long’ ar-

ticle from the pen of M. ERNESTMARTINI, on the employment ofbelladonna ag’ainst scarlatina.It has been extensively used bythe German physicians, and withthe most decided success ; for

. Since the publication of Dr. La-ragna’s cases in TRE LANCET, this re-medy has been tried at Guy’s- and St.Thomas’s with success, as well as inprivate practice.

-

children who had taken thismedicine, and were exposed to

’

the influence of scarlet fever in

general escaped, , while thosewho did not take it, and wereplaced in the same circum-stances, were generally attack-ed by it. Two grains of recent-ly prepared extract of belladon-na, dissolved in an ounce ofcinnamon-water, form the mix-ture, of which two or. three

drops are to be given to chil-dren of a twelvemonth old andunder, morning- and evening.This dose, increased by as manydrops as the child has years,is carried to twelve drops,which is the maximum bothfor children of twelve yearsof age, as well as for individualswho are older. The principleon which it is given, is that of

curing diseases by the exhibitionof remedies which produce symp-toms similar to those of the dis-ease of itself, a mode ot treat-ment introduced by Dr. HANNEMANN.

We shall give next weeka detailed account of the talia-cotian operation, performed byM. DELPECH, and mentioned in

our last, together with some’

comments on the cause of failurein Mr. TRAVERS’S case.

We understand that the holeand corner’ surgeons at St. Thomas’s, are exclaiming, ’ Parcenobis, precamur,’ we will,there-fore, spare them for one weeklonger.We had intended saying a

few Words to Dr. J. JOHNSON,concerning his sage remarks onM.- --Magendie’s experiments.We must postpone it, however,, to a future number.-

-

52

To the Editor of the Lancet.

-SIR,—AS my knowledge ofMr. Jukes and Mr. Scott, andtheir proceedings since- JBme1822, (when - my acquaintancewith them commenced) war-ranted a belief that they wouldnot be over scrupulous in theobservance of professional eti-quette I confess I was notmuch surprized at the letter ofMr. Read, in " The Lancet" ofthe 15th of May last, in whichMessrs. Jukes and Scott’s namesare referred to. As you have,in your inestimable and widelydiffused Journal, given publicityto a variety of letters and state-

.

ments respecting " The Sto-‘

mach Syringe, I have not theleast doubt that you will affordequal publicity to the present.In that hope, therefore, Ibeg to correct an erroneous

. impression which you, and thou-sands of others have hithertolaboured under -on this subject;by stating broadly, that the firstSyringe (in England at least)for the express purpose of with-drawing poison from the sto-

mach, was made by my work-men, under my special direction,on the 2d of July, 1822, Withoutthe slightest hint or suggestionfrom Mr. Jukes, Mr. Scott, orany other person; and that

previous to Mr. Read’s exhibit-ing his Syringe at the BoroughHospitals on the 21st of Novem-ber last, I had sold upwards oftwenty for this special purpose.One of which, to, Mr. Ward, ofNottingham, had been used bythat gentleman successfully, inan actual case of poisoning’ bylaudanum, of a female in an ad-

vanced state of pregnancy, towhom he was called, and whowas afterwards safely delivered.

This case occurred also pre-vious to Read’s visit to Guy’s,and was mentioned in severalprincipal papers. So much atpresent, therefore, for the -cbfi-sistency of Messrs. Jukes andScott, the " novelty" of Mr.Reads invention, and Sir Ast-ley Cooper s- extraordinary eu-logiums upon those persons.But as I cannot expect to oc-cupy your pages with more mi-nute detail, I have determinedby the’ advice of many valuedfriends,-to announce to your rea-ders that I Have nearly readyfor the press, in a distinct pam-phlet, " An Address to the Me-dical and Surgical Profession ofEngland, Scotland, and Ireland,containing a Narrative of Facts,and Observations, illustrative ofthe Motives of Mr. Jukes (aidedby that " Eminent Pracliti-oner,.’.’ his friend, Mr. Scott) inimposing upon the SurgicalProfession and the Public, byassuming’ a character; to whichbe knew he was not intitled,naiiely, " Inventor" of the Sto-mach Syringe, together withstich important additional infor-mation, as will create no smallsurprize in the profession."this " Address" I expect-

will be published within four- ’-teen days from this date, and Ishall- have the honour of send-in- you one of the first copiesi or- review, if you should deemit deserving such notice, Noram I unmindful of the necessityto account for my seeming ex-traordinary delay in making- thisdisclosure, which will be satis-

factorily done—but in the mean

53

time, I beg to state, that the de-lay has been occasioned by cir-cumstances over which I had nocontroul. I am, Sir,Your most Obedient Servant,

JOHN GILL.45, Salisbury-square, Fleet-street,(late of Warwick-place, Bedford-row.)17th July, 1824.

HOSPITAL REPORTS.

GUY’S HOSPITAL.

The Continuation of the caseof F. P. in Luke.June 30.—He left off takingthe soda and opium as he said itKept his head always giddy, andalthough he had a restless nighthe could not be persuaded thismorning July 1st to resume it. HeHas fotind the poppy fomentationand poultice very comfortable,anclw the swelling continues todiminish. His tongue is gettingcleaner; and he is not so thirstyas before, pulse soft and not

more than seventy-eight. Thebowels being rather constipatedIte took some house physic; (the--cathartic mixture), which an.;swered the purpose. Says be is,in no pain, but feels very weak.

July 2. Had a good night; andthe swelling is so much reducedthat he has omitted the fomen-tations and continues only alightPoultice over the Darts. SirASTLEY saw him to day, andthought it would be better fohim to wear a short elastic catheter in the perinæum until higeneral health is improved ; anas his tongue was moist and hipulse rather feeble, he order

him a pint of porter, daily, andsaid that he must not be limit-ed as to diet.3.— he is very cheerful thismorning, and complains of nopain; he could not bear the irri-tation of the flexible gum cathe-ter in the wound, and it wastherefore withdrawn last even-ing by himself; he has no returnof fever since he took the potter,but on the contrary—for the firsttime within the last fortnight,he has had an appetite forfood ; his pulse is a tittle futier,but not hard, and his tongueis moist.—The opening in theperinæum continues to contract.

5. He continues still improv-

ing in appearance; his pulse isseventy-five and fuller; his ap-

petite good; his urine still passesby the Wound in perinæo; thepoultice is left off.6. —He is just as we describedhim yesterday, and when thewound in the perinæum closes,and the urine escapes through thenatural passage, we will againmention the case; the constitu-tional irritation having subsidedthere can be little variation inthe symptoms until the eventswe have just. alluded to, takeplace.

The case of wound of the fa-rynx and neck stated last weekis doing very welt; he has nodifficulty of swallowing; nocough, or any other unfavourablesymptom.

! Whilst the pages of theLANCET are - devoted to the .detail of- the interesting’ ex-periments of rnen justly cele-brated for their physiological re-searches, experiments having for

: their object, the elucidation of