Three Cases: One with the Usual Symptoms of General Paralysis, One with Doubtful Symptoms, and the Third with Marked Symptoms; Pachymeningitis in all. [With illustration.

Abstract

The three Cases following are not so very rare, but are still of interest from several points of view. In Bethlem we have yearly ten or twelve post-mortems on more or less acute cases of general paralysis, and in general hospitals cases similar in the main, with but little mental perversion, but with weakness of mind are common, yet it is rare for the general pathologist to come across cases of pachymeningitis. This condition, if not solely found in general paralysis, is by far more common in this than in any other disease of the brain. In Bethlem, out of over 100 cases of examination after death, these are the only three well-marked examples of this condition of the membranes we have met with. In one other there were slight effusions occurring with fits, but these after death were found only as very thin discoloured layers, three in number, together not being above one-eighth of an inch in thickness. In the first case, the membrane was complete, and resembled a dark, sodden dura-mater, and was very complete over the whole sides and vertex of the brain. It was absent from the base, though here there was a staining at the edge of the membrane.