G. BRAIN. — Here, tumor-like symp toms exist during life, with headache, paralysis of the abducens, congestion of the optic papilla, and attacks of uncon sciousness.
Necropsy indicating the probable mode of infection of the orbit and brain. Sinus found leading from the orbit to the gum of the upper jaw; 'the ray-fungus had probably lodged in or near a tooth, as it has so often been found to do. The fungus was probably carried into the system on an ear of corn chewed at har vest-time. Having reached the orbit, it crept along its outer wall and in the wall of the right cavernous sinus to the base of the brain, ultimately setting up meningitis and small abscesses, and bur rowing through the pituitary body and sella Turcica to the cavernous sinus of the left side. In all probability the dis ease had reached the cranial cavity be fore admission into the hospital. W. B. Samson (Brit. Med. Jour., June 27, '96).
Cerebral complications and death in a case of cervico-facial actinomycosis in a man aged 61. At first localized in the region of the left inferior maxilla, where it was mistaken for periostitis from den tal caries, it invaded later the upper part of the neck and the temporal region.
Here it caused a subperiosteal abscess, which, spreading to the spheno-maxillary fossa and the back of the orbit, finally infected the meninges through the sphenoidal fissure. A secondary infec tion by a slender bacillus produced an abscess in the left temporal lobe contain ing Redd pus. This abscess burst into the lateral ventricle, which was consider ably dilated, and produced coma and death about seven months and a half after the appearance of the first symp toms. Bourquin and de Quervain (Rev. Me'd. de la Suisse Rom., Mar. 20, '97).
Diagnosis.—When the process is very rapid, actinomycosis may stimulate acute phlegmonous inflammation and myelitis; or, when wide-spread, syphilis. SARCOMA. — This form of neoplasm does not suppurate or break down so early.