The clinique médicale; or, reports of medical cases / Condensed and translated, with observations ... from ... medical authors: by D. Spillan.

Andral, G. (Gabriel), 1797-1876

Date:: 1836

Credit: The clinique médicale; or, reports of medical cases / Condensed and translated, with observations ... from ... medical authors: by D. Spillan. Source: Wellcome Collection.

40/1050 (page 18)

$ration still accelerated ; in the course of the day the tracheal rale set in, and the patient died in the night. Post mortem.--T\\e upper part of brain and meninges being minutely examined, no morbid appearance was detected ; but on examining the lower surface, the pia mater covering it was infiltrated with a puruient layer from seven to eight lines thick. Chest.—Lungs very much engorged, as the lungs of apoplectic patients, or of animals who die a certain time after a division of the pneumo-gastiic nerves ; the right cavities of the heart distended with clots of considerable consistence j the left cavities empty. Remarks.—In this case and in the preceding the lesions found in the dead body were similar, and had the same seat ; yet, how different were the symptoms in both cases ! In the latter case, the seat of the headach was far removed from the place where the autopsy detected the lesion. The several bleedings seemed to exercise no influence on the pain of the head ; a little after them, the patient, without any previous disturbance of intellect, fell into a state of coma, which became every day more and more profound. Up to the end the pulse continued natural, and it was only towards the termination that the respiration became disturbed, and death seemed the immediate result of the disturbance of this function. The slight disturbance of digestion was but sympathetic. The vomiting, which showed itself at the same time as the pain of head, seemed of the same nature as that which so frequently accompanies the acute hydrocephalus of children, depending equally on disturbance of the nervous centres. The constipation observed in this case is an ordinary symptom when the brain is affected. CHAPTER III. DISEASES OF THE MENINGES COVERING THE PARIETES OE THE VENTRICLES OF THE BRAIN. The cellulo-vascular web extended over the parietes of the lateral ventricles is not visible in the natural state, but becomes so from the effects of disease. Over these parietes may be observed at times large veins filled with blood. We thought this venous engorgement coincided pretty often with a greater or less collection of limpid serum in the cavities of the ventricles. We never observed on the surface of the parietes of these cavities a fine injection similar to that which appears often on the pia mater around the brain. In more than one case we found, in the interior of the ventricles, either limpid serum in great quantity, or even a milky fluid, pus, membranous flocculi, like those of the peritoneum and pleurae; and in those different cases where there existed within the ventricles so remark- able an alteration in the secretion, the membrane furnishing the morbid product did not itself present any appreciable alteration. These ventricular meningeal in- flammations are very seldom found to exist separate ; they most frequently co- exist with meningitis of the base or convexity of the brain, and their symptoms are confounded with those produced by inflammation of the meninges of the other parts of the encephalon. The following cases may be interesting as rather uncommon instances of isolated ventricular meningitis. Case 17.—Sero-jrurulent effusion into the cerebral ventricles—Cystitis—Violent pain of head at the commencement., afterwards delirium, coma, tongue dry, retention of urine. A man, twenty-nine years old, a saltpetre maker, residing in Paris for the last$