Intracranial tumours / by Byrom Bramwell.

  • Bramwell, Byrom, Sir, 1847-1931.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Intracranial tumours / by Byrom Bramwell. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    In the second place, the new growth necessarily presses upon or involves special structures and parts; and it is to the derangements which are produced in the structures, which are thus pressed upon or involved, that another great and most important group of symptoms —the localising symptoms, as they are termed—is due. The exact nature of the localising symptoms depends upon the following points:— (1.) The function of the particular part of the cerebrum, cere- bellum, pons, medulla, intracranial nerves, blood-vessels, membranes, bones, &c, which is pressed upon or involved. This point is self-evident, and needs no amplification. It is quite obvious that in a case in which the tumour is situated in the neigh- bourhood of the fissure of Eolando, and in which the motor centres are pressed upon or involved, the symptoms will be quite different from a case in which the tumour involves the prefrontal or occipital lobes; and that the exact character of the paralyses or spasms, which are present in the former case, will depend upon the exact portion of the motor area which happens to be affected. (2.) The manner in which the part which is pressed upon or involved by the tumour is affected—whether irritated or destroyed— and, more especially in the case of destroying lesions, the extent of the changes which are induced in it. Speaking generally, it may be stated that the effect of all lesions on the nervous tissues is to produce one or other of two results, viz., either diminution or abolition of function on the one hand, or increase of function on the other. It must, however, be remembered that the increased function, which results from pathological causes, is seldom a simple increase; as a rule, the function is not only increased, but is also perverted iii character. Paralysis, anaesthesia, and dementia are good examples of diminished or abolished function ; convulsions, neuralgia, and mania of increased and perverted function. In some cases in which the symptoms are indicative of increased function, the primary lesion is probably, as Dr. Hughlings Jackson has suggested, a destroying one, i.e., a lesion which produces diminution or destruction of function. It would appear, for example, that in some cases of mania the highest and most specialised parts of the cerebral nerve apparatus are put hors cle combat, with the result