DORCAS WINGROVE, æt. 23, servant, admitted on the 6th day of fever.
Attack commenced with violent pain in the head, preceded by no other
symptom that was observed; this pain still continues exceedingly severe,
and is confined chiefly to the right eye; mind distinct; no sleep; much
restlessness during the night; countenance pallid; no uneasiness of
chest; abdomen tender; bowels constipated; tongue pale, clean and moist;
pulse 93, weak.
7th. Pain of head undiminished; delirium; three stools in bed; tongue
brown and quite dry; pulse 100, firm, strong, and sharp. C.C. ad ℥xij.
nuchæ.
8th. Pain of head gone; no sleep; noisy delirium; stools in bed; pulse
120, weak.
9th. Slight, but very transient amendment.
11th. Comatose; lies quite prostrate; stools in bed; pulse 130, feeble.
12th. Died.
_Head._ Membranes vascular; arachnoid opake; corpus striatum in part
highly inflamed, in part softening to suppuration; viscera of thorax and
abdomen healthy.
CASE L.
THOMAS PROCTOR, æt. 45. Date and progress of disease unknown: at present
perfectly insensible; extreme restlessness; eyes dull and vacant; tongue
dry; pulse scarcely to be distinguished.
2d day after admission. Insensibility the same; almost constant moaning;
features sunk; expression of countenance anxious; pulse 118. Next
morning died.
_Head._ [In falciform process of dura mater an ossification, two inches
and a half in length and half an inch in breadth, with several similar
ossifications along the course of the longitudinal sinus;] the arachnoid
and pia mater consolidated into one thick, opake and yellow membrane;
substance of brain highly vascular and very soft; cerebellum quite
disorganized, being broken down into a yellow, puriform mass of matter,
a considerable portion of which lay loose on the floor of the cranium;
all the ventricles full of serum, in which floated numerous flakes of
lymph; base immersed in similar fluid. _Thorax._ Viscera healthy.
_Abdomen._ Mucous membrane of jejunum and ilium much inflamed, neither
thickened nor ulcerated; [liver greatly enlarged; walls of bladder half
an inch thick.]
The following is placed at the end of the cerebral cases, not because it
illustrates any new circumstance in the condition of the brain, but
because, while the symptoms and the pathology are prominently cerebral,
it affords one of the most complete examples of the peculiar affection
of the joints already referred to.
CASE LI.
GEORGE CARTER, æt. 28. Admitted on the 4th day of scarlet fever: throat
sore; deglutition painful; cough; no pain of chest or abdomen; nausea;
tendency to vomiting; no pain of head; mind distinct; pulse 108, weak.
5th. No pain; eyes suffused; pulse 120, firmer.
6th. Mind confused; eruption partial, interspersed with papulæ; tongue
of strawberry appearance, and rough from prominence of papillæ; pulse
124.
7th. Delirium, so violent as to require restraint; no sleep; pulse 120.
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