File:A system of practical medicine (1897) (14592341960).jpg

Identifier: systemofpractica04loom (find matches)
Title: A system of practical medicine
Year: 1897 (1890s)
Authors: Loomis, Alfred L. (Alfred Lebbeus), 1831-1895, ed Thompson, W. Gilman (William Gilman), 1856-1927, joint ed
Subjects: Medicine
Publisher: New York, Philadelphia, Lea Brothers & co.
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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sionally observed. Tumors of the cerebellum usually cause well-marked general symp-toms of intracranial growth, such as choked disk, headache, vomiting,and, not infrequently, dizziness. General convulsions occur in a numberof cases. Localizing symptoms may be present or entirely absent,depending upon the seat of the tumor and the structures irritated, com-pressed, or destroyed by it. Unless the middle lobe or the ))eduncles ofthe cerebellum are directly or indirectly interfered with, all symptomspointing to the exact seat of the tumor are absent, so that a growthsituated in one of the hemispheres, and sufficiently small so as not tocompress tiie middle lobe, is unattended by any special localizing symp-toms. The most ))ron<)unced and constant localizing symptoms of tumorof the middle lobe are the disturbed muscular movements, limitedlargely to the legs, but observed to a less extent in the trunk. Thegait is reeling, the jiatient has a subjective sensation of insecurity in PLATE VI.
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The Cerebral Fossae, Showing the Position of theCranial Nerves at tiie Base of the Brain. TUMORS OF THE BRAIN. 475 the upright position, and walks with short steps and feet widely sepa-rated. In standing, especially if the feet are held near together, thebody sways to and fro, and in some cases there is a tendency to fall,apparently by forced movements in one direction, whenever the equi-librium is lost. Forced movement backward is said to be less frequentthan forward or to one side. The gait is uncertain or zigzag, and verymuch resembles that of a drunken person, and has received the nameof cerebellar titubation. When the patient is in a recumbent position thelegs are moved fairly well, thus differing in this respect from the ataxiaof posterior spinal sclerosis. The knee jerks may be normal, increased, orabsent. They are often variable, and rarely present continuously unlessthe tumor is situated well forward and compresses the pyramidal tracts.A tremor is occasionally observed in the

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