DOI: 10.7925/drs1.ucdlib_280662
title: Abscess in the brain

description: Watercolour medical illustration depicting abscess. It has the alternative reference number 1405 and P15A on the front. The Richmond Hospital Museum reference is D.a.11. The entry for this in P263/1 pg. 16 reads 'Abscess in the brain. Bridget D'Arcy aet 25. Mr Hamilton'. Includes stamp of Thomas Creswick papermakers in the top left corner. The artist's name is in the bottom right corner 'J. Connolly fec.t' and in the left 'Case of Bridget Darcy Aet 25'. The typescript note on the back begins 'Abscess in the Brain'.
description: Scope and content: The full typescript note on the back reads 'Abscess in the Brain- Mr Hamilton exhibited a specimen of abscess in the brain, and gave the following history of the case:- A young woman, aged 25, was admitted into the Richmond Hospital, labouring under some affection of the head. Her manner was extremely odd, and at times she appeared quite silly, laughing without any cause at one moment, and at another becoming extremely dejected, moaning, and pressing her hand to the right side of her head. Sometimes, again, she would become excited and hysterical, especially if stared at. She gave a very imperfect history of her illness, her memory seeming much affected; but as far as we could learn, she had been suffering from an intense pain in the right side of her head for more than a month. Sometimes it was so intense as to prevent her knowing what she did; it was also intermittent, subsiding for some hours, and the returning with increased violence. Before she came into the hospital a small swelling formed on the side of her head, and a medical man whom she consulted made an incision through it down to the bone. The wound, on her admission, presented the appearance of one connected with carious bone, but on introducing a probe, it did not communicate the sensation of striking against diseased bone, but passed very freely under the temporal fascia; and the surgeon who made the incision remarked that it produced much less pain than usual. Her state soon became much worse; she scarcely answered any questions; if told to show her tongue, she would keep it protruded like a person in fever, and frequently if her mouth was opened it was found full of food, as if the instinctive action of swallowing was not performed. She soon began to pass both urine and faeces under her, and became comatose. The treatment adopted was that usually pursued in such cases; leeches were applied, cupping, and large blistering, and she was brought under the influence of mercury. As soon as the mercury began to act on the system, some amendment took place. She recovered from the state of coma, and became, to a certain degree, sensible, so that I had some hope for her recovery. But the improvement stopped short here, and I perceived now, for the first time, that she had a slight degree of paralysis of the right side of the face. She had also slight convergent strabismus, chiefly of the right eye, the pupil of which was dilated. The pulse at first was upwards of 100, but while in the comatose state it fell to 50, and remained at that number until the end of her illness. She again, by degrees, became unconscious, and fell into a profound coma. Before she sank into the coma the second time, the strabismus disappeared, and both pupils became dilated; and when her eyelids were opened, the eyes remained fixed and staring. The right hand was held, with some rigidity, across the breast, and when an attempt was made to raise it there was a certain degree of resistance. I now held a consultation with my colleagues which resulted in the opinion that the operation of trephining would not be followed by any beneficial consequence. After remaining in a state of coma for sixty hours, the patient sank. I was anxious to ascertain the condition of the brain which produced these symptoms, and also to discover what was the state of the bone. We found, on removing the integuments, that the pericranium was detached from the bone in the situation of the incision, and that the bone itself was slightly rough. The corresponding portion of the dura mater was easily separated from []'.
description: Numbering/sequence: Original reference number: 1405.
description: Date details: This illustration is undated, approximate dates are given based on dates for the entire collection.