Medico-Chirurgical Review

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Excerpt from Medico-Chirurgical Review: American Reprint

Next comes a series of remarks on the phenomena and causes of congestion of the brain, including the powerful influence of mind in its production. Several of the cases may be truly said to possess great practical interest, in reference to the discrimination and treatment of this disease. The consideration of deficient development or subsequent wasting of the limbs, next follows; from affection of the brain or of some part of the nervous system, leading on to a number of interesting and various practical illustrations.

The next condition of brain noticed is that of serous effusion; a condition, which may almost always be distinguished during life; and here it is satisfactory to observe, that where the existence of the disease is most clear, and where its progress has induced obvious enlargement of the cranium, a prompt recourse to active treatment may be attended with perfect and permanent recovery.

Injury of the head from the passage of the electric fluid through the brain, comes next in order; and here is drawn a curious and close parallel between the symptoms of concussion, extravasation, inflammation, and effusion, as induced by this cause, and as brought on by the more ordinary modes of external violence. Inflammatory affections of the brain offer some interesting distinctive features; and it may be remarked, that, when the excitement is superficial only, the symptoms may differ essentially, with the tissue principally involved, whether venous or arachnoide. The occasional and curious influence of abscess in the brain, near the origin of the olfactory nerve, in giving rise to a false sensorial impression is noticed, and practically illustrated. The formation of a large abscess in the lateral ventricle, without its having excited the least mental disturbance, is curious; but the production of several large abscesses in the substance of the brain (two of which abscesses are distinctly and demonstrably seen to be situated one within the other) is still more so.

The formation of hydatids in the brain may present symptoms by which this complaint may be distinguished from ordinary serous effusion, which it most resembles. Ramollissement of the brain should excite much close consideration and interest in the practitioner, from the discordance of opinion which still exists as to its cause, and consequently its treatment; while even its diagnostic symptoms are by no means uniformly admitted or generally understood. The practical illustrations under this title may, it is hoped, be regarded as affording some useful and important light.

Effusion of blood within the head is next considered; and whether from an internal or external cause may generally be discriminated. The severely painful affection, tic doloureux, was long supposed to affect only the nerves of the face; but experience has shewn the more extensive range of its influence; and the cases demonstrate its direct power of deranging not only the nerves of sensation in the body and limbs, but the various ganglia and organs supplied by the sympathetic system, the nerves of sense, and even the sensorium itself. The discrimination of the causes of compression of the spinal cord in the neck is important, and the agency of some of these causes obscure; several of the illustrative remarks on their operation will be found interesting and rare.

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