Sudden death of a soldier who was considered to be in perfect health. the autopsy showing a multiple abscess of the left frontal lobe. The man, at the time of his death, was reclining, on a bench. reading. a newspaper. A few weeks previously he had reeeived a gun shot flesh-wound of the arm, in an en gagement with robbers. which had healed readily, 1 he bone not having been in jured. The abscess was evidently sec ondary to the injury of the arm. though not a single symptom—mental or phys ical—suggested its presence. Sur5reon Turner, U. S. A. (N. Y. Med. Jour., Mar. 14, '91).
The brain may be, and often is, at tacked in general pymmia and cremia, and tuberculosis and syphilis affecting the encephalon may present the local conditions of abscess. Various con stitutional diseases of infectious origin, among which may be mentioned small pox, typhus and typhoid fevers, grippe, and cerebrospinal meningitis are sionally complicated with brain-abscess.
Three cases of abscess in the right cerebral hemisphere, all occupying nearly the same position in the centrum ovale, all attended with left lateral homony mous hemianopsia, with great weakness of the left arm and leg, the loss of power being greater in the leg than in the arm, the face escaping almost en tirely, and with sensory impairment on the left side. Thc infective material in two was probably derived from distant suppuration, and in one from an injury of the scalp although the incomplete post-mortem examination renders this uncertain. J. T. Eskridge (Med. News, July 27, '95).
Two cases of metastatic abscess of the brain from primary actinornycosis of the lungs. Both eases were considered clin ically to be of tuberculous origin. C. H. -Martin (,Tour. of Path. and Bact., Nov., '94).
Aphasia during convalescence after evacuation of brain-abscess. Dr. Jack's case corroborates the view of Broca and Troussean, who first maintained that there is no writing-centre in the sense of a centre in which are stored lip the kinesthetic memories of written words and capable of stimulation independ ently Broca's convolution. The in ability to write in this case was abso lutely coincident with the inability to talk. When the auditory centre either failed to recall the memory of the sound of the word, or. if remembered, failed to convey the stimillits properly to the kinesthetic speeeli-centre. it failed also to communicate it to the centre for the movements of the hand. That the centres
and fibres affected were not destroyed is shown by tlie complete recovery. G. L. Walton (Boston Med. and Surg. Jour., Dec. 26, 1901).
Pathology and Morbid Anatomy.— Brain-abscess is always secondary to the intracranial invasion of pyogenic micro organisms. The growth of such abscess is steadily progressive except when, as occurs occasionally, a membranous wall of tissue develops, inclosing the pus and preventing its encroachments upon surrounding structures; when so sur rounded, the abscess is said to be of the incapsulated variety. When incapsula tion occurs the further progress of the disease is temporarily and sometimes for long periods of time arrested. The dan ger of rupture is always present, how ever, such rupture resulting in sudden apoplectiform symptoms with death, the picture simulating a sudden vascular lesion. In its incipiency brain-abscess presents the local appearance of what has been termed "acute, red softening." Later the pus' changes from a reddish yellow to a greenish or greenish-yellow color, and is at times quite offensive in odor when exposed. The complications usually found are sinus- phlebitis and thrombosis (lateral and superior petro sal), leptomeningitis, extensive meningo encephalitis, and purulent pachymenin gitis. Leptomeningitis and sinus-throm bosis are especially common in cases due to aural disease.
Charcot and Leyden crystals found in pus from cerebral abscess. These crys tals have been found in the expectora tion of asthmatics, the freces of amemies, from the Anehylo*toinitin ditodenale, in the semen, in and in other conditions. So far, they _seem to have no constant sig,nificanee. Campbell (Med. Chronicle, Feb., '94).
The streptothrix found in a ease of abscess of the brain characterized dur ing lifo by epileptiform attacks. This streptothrix developed well in different culture-media. though only completely on potato. In the primary pus and in the potato culture it presented the form of ramifying filaments with knob-like terminations. It stained well by Gram's method. Inoculated into the guinea-pig it did not prove pathogenic. Inoculation into a rabbit caused diffusion of the parasite in the organism without phe nomena of reaction or of pseudotubereu losis. Ch. F6r6 and Faguet (Le Bull. 11.16d., Aug. 25, '95).