| OCR Text |
Show [MEN 310 or 1'er FUNGUS CEREBRI. There are three kinds of tumours which may arise in conse. quence of part of the skull being taken away. 1. A fungous excrescence from the dura mater. 2. Mr. Abernethy describes " a state of protr usion, which has been described by others as prodigious, on account of its rapid growth, &e. This he athrms, in three instances, to be owing to efl‘usion of blood, which was a hama sarcoides." This I have not seen. 3. The last is the proper fungus cerebri. When a large portion of the cranium has been taken away, either by caries or the trcpan, or when the trephine has been used, and the dura mater hurt by the teeth of the saw; or,- lastly, when the edge of'the skull has been left sharp and ragged-then, by the pulsation of the brain, whic h forces the dura mater upon the edges of the opening, that membrane 2.1" i 47'7"" [lin(( -g~ ""4"t t is in part cut, in part ulcerated. At this place the support which is natural to the brain is taken away, and the diseased part of the brain, and the ulcer whic h was forming, sends out a loose fungus; and, perhaps, in some instances, part of the brain itself is in the first instance protr uded. Whilst the tumour rises outwardly, there is proceeding at the same time an ulceration in the surface of the brain ; and from this diseased portion of the brain, there rises, in consequence of the want of the natural degree of compressio n, a luxuriant fungus; or the soft surface of the brain yielding, it bursts, perhaps in consequence of violent coughing, and from it this tumour arises. Very soon after the separation of the bone, and the ulcera~ tion of the dura mater, the protrusion begins se. In the commencement, and daily during the continuanc e of sensibility, the patient complains of a cold shivering, and pain in the head ; his countenance is of a pale, dirty, cadaverous yelloW» As the tumour increases he has frequ ent sickness, is giddy, and reels like a drunken man; the pulse becomes slow and weak; My CQSC'bOOk 51559 on the second day after the separation of an exfolim tic-n. or run rose as CEREBEI. 311 he betakes himself entirely to bed ; can no longer sit up; becomes incoherent; he lies oppressed, and his pulse is a mere tremulous motion of the artery. The disease runs its course in about eight da 5. These are the symptoms, as I have observed them, when originating in exfoliation from the venereal disease, and where consequently it is. natural to suppose that there was no prevr- ons injury of the brain, as there may be in the case of fracture. I conceive this fungus of the brain to be attended with the utmost danger ; that the tumour should be cut freely off; and if it bleeds, so much the better; and that after this there should be slight and equabie pressure. I conceive also that the pressure and growth of the fungus keeps up high vascular action in all that part of the brain to which it is attached; that as in other instances the cutting off of an excres- cencc from a tumour checks the activity of vessels, so here it will also allow the matter commonly formed behind to es- cape. W'hen nature performs a cure, it is by the fungus being choaked, and dropping off, either in consequence of its own rapid increase, or in consequence of the growth of the granulations of the scalp and bones. WON! M09: |
