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If the grown man has a fit, and still more, if that fit is followed by paralysis, we fear and with reason that some vessel in the brain-substance has given way, or that some grave, probably irreparable damage has been inflicted on it.
Occasionally a deficiency in the osseous material of the cranium or an abnormal dilatation of the fontanelles gives rise to a hernia of the meninges, which, if accompanied by cerebrospinal fluid in any quantity, causes a large and peculiarly shaped tumor called meningocele. If there is a protrusion of brain-substance itself, a condition known as hernia cerebri results.
Why in the thousand and more observed forms of snow-crystals the filaments of ice should always be arranged at angles of 60 degrees or 120 degrees; why sulphate of potash and sulphate of alumina should crystallise in octahedrons or in cubes, but in no other forms; what is the real connection between molecular changes in the brain-substance and states of consciousness all these, and a myriad more, are unsolved mysteries: we can only say that we are dealing with facts of experience.
In 1846 there is a record of a man of forty who fell from a scaffold, erected at a height of 20 feet, striking on his head. He was at first stunned, but on admission to the hospital recovered consciousness. A small wound was found over the right eyebrow, protruding from which was a portion of brain-substance.
There was visible a triangular depression, from which, possibly, an ounce of brain-substance issued. This man also recovered. Jewett mentions a case in which an injury somewhat similar to that in Bigelow's case was produced by a gas-pipe.
The anterior lobe of the brain was evidently much wounded; an incision was made in the forehead and a portion of the frontal bone chiseled away entrance being thus effected, the aura was incised, and some blood and cerebrospinal fluid escaped. Five splinters were removed and a portion of the damaged brain-substance, and a small artery was tied with catgut.
The pin was pulled out by the boy, who washed his own face, and lay down; he soon became semi-comatose, in which condition he remained for some days; but, after operation, he made complete recovery. Loss of Brain-substance from Cerebral Tumor. Koser is accredited with reporting results of a postmortem held on a young man of twenty who suffered from a cerebral tumor of considerable duration.
At the autopsy are found hyperemia of the arachnoid, and slight chronic leptomeningitis and pachymeningitis. There is also anemia of the brain-substance. In one of his cases the spleen was enlarged. He was inclined to regard the disease as a neurosis.
It seems the very depths of total depravity when there is no bread for the hungry family, that the price of a loaf will rather be spent for a drink; but it is not so much moral depravity as depravity of brain-substance. The lethal drink is taken because without it there is more acute suffering than from the want of a loaf of bread by the entire family.
There was copious bleeding from the ears, 50 to 60 fluid-ounces of blood oozing in a few hours, mingled with small fragments of brain-tissue. The next day the discharge became watery, and in it were found small pieces of true brain-substance. In five weeks the man returned to duty complaining only of giddiness and of a "stuffed-up" head.
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