Transactions of the Medical Society of King's College, London.

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Credit: Transactions of the Medical Society of King's College, London. Source: Wellcome Collection.

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    this state he lingered on a long time; there was throughout the case no 'palsy, except that of the facial muscles. Nor was there any rigidity or contraction of the limbs. From time to time he suffered from great dysphagia, which after lasting a short time, went off again. For a long time before his death, he suffered constant and agonising pain in the head, which nothing but opium would relieve at all. The deafness also greatly increased, and the tongue was perma¬ nently drawn to the left side to such an extent, that it could not be protruded beyond the teeth. The cornea of the left eye, from constant exposure, was sloughing, and apparently just about to burst when he died. I saw him frequently during the last month or two of his life, and his chief distress at this time was from involuntary stools and retention of urine. His intellect never appeared deranged, except that he occasionally had short periods of delirium, which may, however, have been owing to the opium he took. He died on the 20th of September, 1856, between two and three years after the commencement of the pain in the head. Post-mortem examination.—The membranes around the cerebellum were very adherent to the bone, and to the cerebellum itself, especially about the posterior surface of the petrous portion of the left temporal bone, where there was a mass of effused lymph between the membranes, and between the dura mater and the bone, involving and strongly com¬ pressing the fifth and seventh nerves. The whole periphery of the cerebellum, but especially on the left side, was very much softened, apparently in an inflammatory manner. In the centre of the organ there was developed a large tumour, which could be readily separated clean from the surrounding nervous matter. It was about the size of a large walnut, and very firm; and in section it displayed a fibrous structure.