282 MORBID ANATOMY.
impaired ; and attempts to raise the lid caused severe pain in the eyeball. Never any cerebral symptoms.
The man stated that the tumor had a bony feel from the first, but that, at the end of a year, a fluctuating spot appeared toward its inner border, was punctured, and dis- charged a sanious, watery, purulent fluid ; the tumor be- ing then, and subsequently, exceedingly painful. Some months afterward it was punctured again, in the same spot, and with a similar result. At that time, July, 1863, he had tj'phoid fever ; and the tumor afterward increased with great rapidity.
Oct. 19th an operation was performed, when a thin shell of bone, deficient at various points, was found expanded over the tumor ; and, between the two, a quantity of degen- erated pus. Two slices of the tumor were removed by an amputating saw ; and then, with the mallet and chisel, the remaining portion was cut down to a level with the frontal bone, and gouged out from the orbit, so that the eye could be restored to its natural position. Of four chisels that were used, the edge of but one could act upon the dense ivory structure. There was not the slightest sign of vas- cularity in any part of the tumor.
After the operation he did perfectly well till the llth of November ; eating steak, etc., with great relish. Then oedema of the forehead came on, followed by severe head- ache ; but on the 16th he was doing well again. On the 20th he was less well, and had severe pain ; on the 21st, delirium ; on the 23d, coma ; and on the 24th he died.
On dissection, the tumor was found to project internally, as it did externally, and to compress the left anterior lobe of the brain, the whole of which last had been converted into an abscess.
The right hemisphere, where, in contact with the left, was sloughing and purulent for the space of a square inch, but the meningeal inflammation was slight.
In structure, the internal, like the external portion of the tumor was uniformly dense throughout, and nowhere cancellated ; but, from its color and general appearance, it would seem to have undergone necrosis, though, being so devoid of vessels, this could not easily be determined. It
�� �
