In a gumma in the cortical motor zone of the right side the head-temperatures, taken once, were found to be for the right parietal region, 97.2°; for the left, 96°. In another tumor of the right motor zone the right frontal region gave a temperature of 98°; the left, of 96°. In a tumor of the left occipito-parietal region the temperatures were for the right parietal region, 98°; for the left, 97.8°. Although the temperature of the head was only taken once in each of these three cases, the observations were carefully made with tested thermometers.
J. T. Eskridge, in a case of a tumor of the cerebellum with monocular hemianopia (Case 76), made the following temperature observations:
| Axillary | R. 98.6°; | L. 98.6° |
| Head: | ||
| Anterior frontal station | R. 98.4°; | L. 98.4° |
| Posterior frontal station | R. 98.5°; | L. 98.6° |
| Superior frontal station | R. 98.4°; | L. 98.4° |
| Parietal frontal station | R. 99.2°; | L. 98.6° |
| Rolandic frontal station | R. 98.8°; | L. 99.1° |
| Occipital frontal station | R. 99.4°; | L. 99.1° |
| Posterior central station | 99°. | |
| Anterior central station | 99°. | |
The normal average temperatures, as determined by Gray, were as follows:
| Left frontal station | 94.36° |
| Right frontal station | 93.71° |
| Left parietal station | 94.44° |
| Right parietal station | 93.59° |
| Left occipital station | 92.66° |
| Right occipital station | 91.94° |
| Left side of the head | 93.83° |
| Right side of the head | 92.92° |
| The whole head, exclusive of the vertex | 93.51° |
| Motor region of the vertex | 91.67° |
| The whole head, inclusive of the vertex | 92.66° |
We conclude that in brain tumors the average temperature of the whole head is elevated several degrees above the normal, and that the elevation of temperature is usually greatest at the station nearest the seat of the growth.
Mental disturbance of some description was present in about one-third of all the cases studied. Doubtless they were not recorded in a large number of cases. Obernier says: “If the psychical qualities of a patient suffering from cerebral tumor be analyzed, and a careful comparison made of the former with the existing mental condition, certain symptoms of mental disturbance will be discovered in most cases where the tumor is a growing one.” The disturbances may be in any sphere of the mind—in intellection, volition, emotion, or perception. Mental slowness and uncertainty, inability to fix the attention, impossibility of continuous mental action, apathy, or stupidity, with hesitation or slowness of speech, were strikingly exhibited in cases of tumor of the antero-frontal region. In Case 1 the patient's mental condition was studied with great care, and in the detailed report of the case23 the following facts were noted: The psychical manifestations were among the most important features of the case. Although comparatively uneducated, he had been when in health intelligent and energetic. He had never during his illness had the gay humor or delirium of grandeur seen in the general paralysis of the insane. His condition, on the whole, was one of intellectual slowness and uncertainty. He seemed to have great difficulty in receiving mental impressions and in directing the movements of his body. His faculty of attention was, in great measure, destroyed. It could only be fixed, and then but partially, by distinctly and vehemently repeating a question or command. He could hear, but it was necessary to make a tremendous external impression on his sense of hearing in order to call out a mental response. He sometimes appeared to me like a man dazed by a great catastrophe which he could not understand. He was not aphasic, although he manifested certain striking peculiarities of speech, or, rather, of the manner of speaking. What he said, either spontaneously or in answer to questions, was spoken clearly and distinctly and in a firm, loud voice. His sentences were short, but complete; neither words nor syllables were omitted; and he made no mistakes in articulation, enunciation, or pronunciation. In answering he did not seem to be able to retain for any length of time a hold upon the same idea or to follow a particular train of thought. He did not wander from one subject to another, but he would suddenly stop speaking, as if unable to go farther. Often on being questioned he would try to reply, and after a sentence or two would sob and burst into tears like a violently hysterical woman. He would at times have what might be termed volcanic outbursts of speech. When all was perfectly quiet in the ward he would suddenly explode with a sentence or two, and then again subside into stillness. Exclamations of this kind might be repeated at intervals of a few minutes for hours together, or they might recur only at intervals of hours. Sometimes what he said would be connected with some past events of which he seemed to have a vague recollection; often it would be a demand for something to eat or drink; and often, again, it would be a paroxysm of profanity.
23 Philadelphia Medical Times, Jan. 18, 1879.
Impairment of will is not uncommon in antero-frontal and other cerebral tumors, and failure of memory, depression of spirits, and even acute mania, occur. Many of the patients are emotional, excitable, and irritable; they often sob and cry, apparently from the great pain. In some cases, however, emotional conditions are present which seem to be dependent on some special localization of the tumor. Hallucinations were noted in two of our tabulated cases. In one case, a tumor of the motor zone, the patient had delusions that some one was about to take him away. There were also illusions of fear or persecution. In another the patient had visual hallucinations.
Speech-defects of various kinds occur in connection with intracranial growths. Ladame, quoted by Rosenthal, has cited forty-five cases of disturbances of speech in which the tumor occupied the most varied regions of the brain. Peculiar disorders of speech from special localizations will be treated of under Local Diagnosis.