softening was found in the right corpus striatum and another in the right thalamus.[1] None of the treatises I have seen on the subject make mention of a variety of this disease intermediate between suddenly fatal cases and those which last several days,—a form in which the patient's illness endures for a few hours only, and which, both in the special symptoms and in their course, imitates exactly the effects of some narcotics. Two such cases have come under my notice, both of them judicial, poisoning having been suspected. One of them proved fatal in an hour and a half, the individual having previously been in excellent health; and the only appearance of disease was softening of a considerable part of the surface of the brain where it lies over the left orbit. The other was more remarkable in its circumstances. In November, 1822, a man, who had previously enjoyed excellent health, was found one morning in a low lodging-house in the Lawn-*market comatose, and convulsed; and he died seven hours afterwards. The neighbours spread a report, that the woman of the house had poisoned him, with the view of selling the body; and by an odd coincidence the police, when they went to apprehend the woman, found an anatomist hid in a closet. The body was judicially examined by Sir W. Newbigging and myself; and we found an ulcer on the forepart of the left hemisphere of the brain, and a small patch of softening on each middle lobe. It is only in cases like the last two that the disease is likely to be mistaken for the effects of poison; and the morbid appearances will at once distinguish them. But it is requisite to remember that softening of the brain when not far advanced is apt to escape notice, as it is not necessarily attended with a change in the colour of the diseased part. In the first of the two cases I have related, the cause of death was very nearly assumed to have been simple apoplexy, when at lenght the true disorder was unexpectedly noticed. I presume, indeed, that strictly speaking, both of the cases which came under my notice ought to be considered as simple apoplexy excited by pre-existing ramollissement. Of the Distinction between Hypertrophy of the Brain and Narcotic Poisoning.
This disease is not here mentioned, because its symptoms and progress resemble very closely those of poisoning with the narcotics; for it causes epileptic symptoms, which, besides that they are preceded for some time by other head affections, very seldom prove fatal in less than three days. But some notice of it is necessary, because the disease is rare and of recent discovery, so that the appearances left by it in the dead body may escape observation. Besides, the physician is at present imperfectly acquainted with it, and therefore, when a more extensive collection of cases shall have been made, it may be found to prove at times fatal so rapidly as to admit of being
- ↑ Recherches Anatomico-Pathologiques, 313.
