562 THE POPULAR SCIENCE MONTHLY 



SUGGESTIONS FEOM TWO CASES OF CEREBRAL 

 SURGERY WITHOUT ANESTHETICS 



By Peofessoe GEORGE TRUMBULL LADD 



ZALE UNIVEKSITT 



FOR the first time, so far as I am aware, there have been placed on 

 record two cases of cerebral surgery, accompanied by somewhat 

 extensive explorations of the brain-substance, without the use of an- 

 esthetics. The suggestions afforded, and the problems further opened, 

 by these cases are so interesting from the psychological point of view 

 that it seems to be desiral)le at least to call to them the attention of 

 this association. Only one of these cases has as yet been reported in 

 print ;^ for some of the facts connected with the other case I am in- 

 debted to correspondence with the operating surgeon, Dr. Harvey 

 Gushing, of Johns Hopkins University. 



Briefly described, the case of which we have the fullest report was 

 as follows. The patient, R. C, was 32 years of age, unmarried, a 

 farmer and teacher, a man quite up to the average of his class in in- 

 telligence, and of excellent moral habits. Previous to the beginning 

 of his present trouble he had been in excellent health. When nine 

 years of age he received a slight blow on the head ; later, he received a 

 blow from a baseball bat which fractured his nose. No other causes 

 of possible cerebral injury were discoverable. About the year 1895 he 

 began " to suffer from curious nervous attacks, which came on without 

 cause." These consisted of strange sensations in the head, and 

 twitchings of the left calf. But there was no loss of consciousness 

 and the seizures lasted only a few minutes. With these symptoms 

 there subsequently became associated tingling sensations, which some- 

 times spread up the left leg even to the thorax and the left arm, and 

 more extensive twitching of the muscles, spreading itself in the same 

 direction. These seizures were followed by numbness in the parts 

 involved; but until July, 1900, there were no fits with complete loss 

 of consciousness; and at the time of the first operation loss of con- 

 sciousness had occurred only six times, although during the ten years 

 previous there had been several hundred seizures. 



The patient had, however, been subject to headaches from child- 

 hood, and these became more and more severe after the nervous at- 



^ " Removal of a Subcortical Cystic Tumor at a Second-stage Operation 

 without Anesthesia " ( reprinted from the Journal of the American Medical 

 Association, March 14, 1908, Vol. I., pp. 847-856). 



