Typhlitis consolidating with high dose arac
Sponge-pressure failing, the hemorrhage was finally arrested with the electro-cautery.
The incision into the cortex being prolonged, the sides of the growth were easily separated by a spatula of steel, readily bent into any shape The superficial surface of the growth being thus isolated, this portion was removed with the finger ■ as part now broke away, the deeper parts were enucleated with a sharp spoon, the scraping being continued till apparently only healthy brain-matter remained Ihis caused rapid welling up of blood into the cavity, which would have held a pigeon's egg.
The cut surface was treated with a strong soutimi of rinc chloride and iodoform, and a cap of block-to Spbed The hernia cerebri again increased somewhat, but all led to be doing well, when, on the twenty first day a n appeared, headache followed and vomiting, then restlessness, Xeplessness, and gradual sinking about four weeks after the ° P M^the post-mortem examination extensive arachnitis was found The parietal area appeared to have fallen in ; in its touna. ASSISTANT-SURGEON GUV's HOSPITAL', LECTURER ON ANATOMY. LATE TEACHER OF OPERATIVE SURGERY IN THE MEDICAL SCHOOL: SURGEON To THE ROYAL HOSPITAL fott CHILDREN AND WOMEN SECOND EDITION WITH TWO HUNDRED AND THIRTY-FIVE ILLUSTRATIONS \WELLCOME INSTITUTE X LIBRARY Coll. TO THREE OLD FRIENDS ARTHUR EDWARD DURHAM JAMES FREDERIC GOOD1IART EDWIN CLIMSON GREENWOOD 3- He£ucate tbis 3Book AS SOME SLIGHT TOKEN OF MY GRATITUDE AND AFFECTIONATE RESPECT i PREFACE TO THE SECOND EDITION. While it testifies to the carefulness of his reading, I trust that allowance will be made for its length by those who know some- thing of the calls upon my time. Its size was now somewhat diminished, and the forefinger could be passed between the cranium and tumour, and by its aid the delicate cellular attachments that held the mass in place were felt to yield easily, enucleation now became possible, and the base was finally reached. At frequent intervals every day the patient's thumb would commence twitching, but the progress of the convulsion could often be arrested by stretching the thumb or applying a ligature. There was frequently severe headache, beginning at the occiput and shooting forward, especially to the right parietal region. It was decided to explore the junction of the middle and lower thirds of the ascending frontal and parie- tal convolutions, a spot at which Prof. Beevor had shown that the movement of opposition of the thumb and finger could be elicited. Operation having been decided upon, a U-shaped flap was raised, and a 1 -inch trephine applied at 1 inch above the occipital protuberance, and the same distance from the middle line, beyond the limits of both the longitudinal and lateral sinuses, and the bone removed until an oval opening 2 J by 2 \ inches was made, exposing a dura mater of a deeper hue than normal ; section of this exposed the tumour, the outlying edges and base of which could not be reached in spite of further removal of the cranium, it was therefore incised and some of its softened, granular and fatty-looking contents forced out. The right lower limb was next attacked, and finally the right upper limb. A cortical lesion of the right motor area, in the upper half of the ascending frontal and parietal convolutions, with prob- able involvement of the paracentral lobule, was diagnosed. Crucial flaps of this being reflected, a yellowish opaque effusion covered the brain, obscuring the con- volutions and bridging the fissure of Eolando. The most interesting case of operation in these cases is one of Dr. In a patient aged twenty- live, there was left-sided motor monoplegia of arm and leg, preceded by muscular twitchings and tingling sensations, without loss of sensation, due to syphilis, and resisting prolonged treat- ment.