. A text-book of medicine for students and practitioners . extent as tocause atrophy of the optic nerve that vision is much impaired. 6. General loss of flesh and strength may sometimes appear comparativelyearly in cases of tumor of the brain. It is due in large part to the small amountof food taken, vomiting, and wakefulness; but it is not impossible that thegrave cerebral disorder itself exerts a direct and unfavorable influence uponall the processes of nutrition. There is in most cases, also, a tendency to ob-stinate constipation. 7. In conclusion we may call attention to the fact that, on
. A text-book of medicine for students and practitioners . extent as tocause atrophy of the optic nerve that vision is much impaired. 6. General loss of flesh and strength may sometimes appear comparativelyearly in cases of tumor of the brain. It is due in large part to the small amountof food taken, vomiting, and wakefulness; but it is not impossible that thegrave cerebral disorder itself exerts a direct and unfavorable influence uponall the processes of nutrition. There is in most cases, also, a tendency to ob-stinate constipation. 7. In conclusion we may call attention to the fact that, on examination ofthe spinal cord of persons who have died of cerebral tumor, degenerativechanges have been found in the posterior columns and posterior roots (Dinkier,Mayer, and many others), besides the ordinary secondary descending degen-erations. These changes are probably a consequence of the increased cerebralpressure and the stasis of cerebro-spinnl fluid thus occasioned, and thus theymay be classed among the general symptoms of tumor. As a rule they. Ilu. IUy.—Oplic (chukfd di«-j in tumor of the brain(after Gowers). TUMORS OF THE BRAIN 535 have no great clinical significance. Only the loss of the patellar reflex, whichhas been observed in some cases of brain tumor (particularly in tumors of thecerebellum), probably depends on the secondary degeneration of the posteriorroots and posterior columns. Tumors in the Different Parts of the Brain and their Focal Symptoms.—The symptoms above discussed indicate the existence of a tumor, but not itsparticular location. Other phenomena are necessary to enable us to localizethe disease, but it is not exceptional to have none but tlie general in the white matter of the frontal lobe, or tumors of the corpusstriatum or optic thalamus, as well as others, nu^y run tbeir course withoutany focal symptoms; biit most cases afford evidence which points with moreor less certainty to the exact position of the tumor.
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