J. P. a man, aged thirty, was admitted into the hospital, October 18th,
1800. It was then deposed, by the persons who brought him, that he had
been for eight months in a melancholic state; but they were unable to
assign any circumstances, which preceded his disorder, as a cause of his
disease. He had a large tumor on the throat which extended backward to the
neck, principally on the left side; the increase of this swelling, they
alledged, had much alarmed him, at the commencement of his melancholic
attack. During the time he was the subject of my observation, he was in a
very mopish and stupid state; if spoken to, he would sometimes give a
short answer, but ordinarily he took no notice of those who addressed him.
Some days he would walk slowly in the less frequented part of the
building; frequently he sat down for some hours in a corner. His appetite
was good, he ate the food which was brought him, but never took the
trouble to go for it, when serving out. In this state he continued until
April 2d, when he became more stupid, and could not be made to rise from
his bed. He did not appear to be in any pain, nor was he at all convulsed.
His bowels were regular. On the 5th he became comatose, and on the 9th he
died.
_Appearances on Dissection._
There was an excessive determination of blood to the brain, and the pia
mater was highly inflamed. On the inferior part of the middle lobe of the
brain, there was a gangrene of considerable extent, together with a
quantity of very foetid purulent matter.
This is the only instance of a gangrenous state of the brain which has
fallen under my observation.