. Modern surgery, general and operative. nic meningitis from syphilis exhibits periods of increase and periodsof subsidence of the symptoms, and usually palsy of one or more cranial symptoms may pass away under the use of mercury and iodid of 914 Diseases and Injuries of the Head There may be clinical evidences of syphilis. There should be a positive Was-sermann reaction. Chronic tuberculous meningitis causes a headache which is apt to be generaland more violent than that of tumor, and there is more commonly cutaneoushyperesthesia and hyperesthesia of the organs of sigh
. Modern surgery, general and operative. nic meningitis from syphilis exhibits periods of increase and periodsof subsidence of the symptoms, and usually palsy of one or more cranial symptoms may pass away under the use of mercury and iodid of 914 Diseases and Injuries of the Head There may be clinical evidences of syphilis. There should be a positive Was-sermann reaction. Chronic tuberculous meningitis causes a headache which is apt to be generaland more violent than that of tumor, and there is more commonly cutaneoushyperesthesia and hyperesthesia of the organs of sight and hearing. Opticneuritis may be absent. When present it is of less intensity than that observedin tumor. In some cases the ophthalmoscope discloses tubercles on the meningitis there is a continued, irregular fever. The cerebrospinal fluidobtained by lumbar puncture usually exhibits an excess of lymphocytes. Itmay contain the bacilli. Carbohydrate is absent. It may be sterile. Ofcourse, a tumor might exist with Fig. 588.—Professor Gibbons case of brain tumor. In Brights disease symptoms strongly suggestive of tumor may arise (head-ache, vomiting, and choked disk) with, perhaps, but little change in the difficulty in diagnosis becomes evident when we recall that in cases ofbrain tumor the urine may contain casts and albumin. A sudden onset andbrief duration of the symptoms suggest uremia. Ependymitis with ventricular dropsy may cause symptoms resemblingtumor with hydrocephalus. Optic neuritis is not so common as in spastic paralysis may arise. Severe anemia is capable of producing symptoms which suggest can even produce choked disk. A blood examination and the rapid improve-ment under proper treatment makes the diagnosis evident. In some cases of brain tumor (especially frontal lobe tumors) there arestriking evidences of hysteria and neurasthenia. Always think of this wheninclined to make a diagnosis of hysteria or
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