Non Nocere (Classic Reprint)

Excerpt from Non Nocere

When the brains of operative surgeons were taken with the furor Operated? On the brains of luckless children, the war-cry was: microcephalus and idiocy. By many the two were identified. Nothing henceforth was required but to open the heads in order to admit light. The literature on the subject having been quite extensive all over Europe, the American facts I intend to give you will require but a brief introduction.

Which are the underlying conditions of idiocy I recall to your minds only the following records of autop sies and anatomical examinations both of the coarser or finer tissues Chronic encephalitis (jeanneret, Stark, Mierzejewski), either diffuse or circumscribed, frequently syphilitic diffuse (syphilitic) disease of the blood-vessels (popoff) arrest of vascular development in the cortex (luys) inequality of the hemispheres inequality of the peripherous cortical layer on the two sides; defect of the third frontal convolution and island of Reil men ingo-encephalitis with thickening and adhesion of pia and brain such as may occur after forceps or other trauma kephalhaematoma internum, spontaneous hemorrhages embolism from heart disease; thrombosis from cholera infantum, followed by destruction of cerebral cells and atrophy of cortex. This condition was found in 21 cases out of a total of 343 collected by Starr. He further re ports Maldevelopment and apparent atrophic condition of the brain-structure of the hemispheres, chiefly cortical, the cells resembling those of a new-born child, but with no apparent gross defects in the brain, 32 cases atrophic or hyperplastic sclerosis, congenital or post-natal, 97 cases; atrophy by softening produced by embolism or thrombosis, and limited to certain arterial districts, 23 arrests of development such as por'encephaly, 132 (fre quently in a thin cranium) cysts which produced atrophy by pressure, or were associated with the atrophy due to the original lesion, 14 hemorrhages which were discerns ible by the remains of a clot, or by the haematin staining of a cyst of the pia or of sclerotic tissue, 18.

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