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Related post: some slight restoration of motion in the right loot and the
ability to make slight extension of the forearm. Control over
the sphincters was normal and the appetite was good, all the
other symptoms persisting. At the end of three months there
was some ability to utter sounds, and apparent intelligent appre-
ciation of printed matter, but articulation was utterly unintel-
ligible and the intellectual faculties were undoubtedly greatly
disturbed. Where Can I Buy Orlistat The patient had come under the care of the speaker
tfiree mouths after the date of the injury. At this titne he could
make some molion in the right toot, and, when supported, some
eflfort at locomotion. The right pupil was diminished in size,
bnt the right side of the face was otherwise uuaffected. There
was Orlistat In Canada an apparent partial appreciation Cheap Orlistat Online of what was said to hiin,
bat the intellect was very much obscured.
The speaker Where To Buy Orlistat had called on Dr. Starr to assist him by making
oat the exact character of the lesion, and without his invaluable
aid he should have felt unwilling to go on with any surgical
treatment of the case. The conclusion was that hajmorrhage
had occurred, sliortiy after the accident, on the left side of the
liead, atlVcting that area of the brain which controlled the
faculty of speech and those of motion and sen.sation io the right
arm and leg. It was also believed tliat this hiemorrhage existed
on the surface of the brain and not on the internal Orlistat For Sale capsule, and
that the general sjmptonis Indicated a cortical and not a deep
le>ion.
An operation was performed a year ago last December with
a view of e.xposing the s|)eech center, and, if necessary, of fol-
lowing up the exploration to' the arm and leg centers, in the
Search for the suspected su[)crficial clot. After making Buy Cheap Orlistat a large
flap, the trephine was applied seven eighths of an inch behind the
angular process of the frontal bono ft, pulpy, cystic-looking How Much Does Orlistat Cost mass which it was decided
must be oedematous pia mater. Anterior to this oidematons
portion the pia and the brain presented the normal appearance,
but behind and above this the pia was dark red and looked as
if it covered the thin edge of a distinct clot. The opening in
the skull was enlarged in an upward and backward direction by
means of the rongeur forceps, and the dura laid open by suit-
able incisions until the entire surface of the clot was exposed.
Thus an irregular piece ot bone 3^ x 2J x 1 J inches was removed.
The long axis of this area was along the fissure of Rolando, and
the greatest breadth was backward from this fissure. The area
of densest blood clot was in the course ot the fissure of Rolando,
and along this the pia was incised from the lower extremity of
the fi.ssure to the highest point uncovered Price Of Orlistat by bone. An old
blood clot was found dipping down into this fissure, and spread
over the neighboring convolutions, especially the middle part
of the postcentral convolution. This portion consisteil of a very
delicate layer of coagulum, and was removed by gently rubbing
the surface of the brain with a soft wet sponge. In this way
the clot which extended down between the convolutions was
removed, as well as that on the surface, and with no apparent
laceration of the brain tissue. All hajmorrhage was carefully
checked by applying ligatures of tine catgut to bleeding pidnts.
The dura was sewed up with fine Orlistat Australia catgut, except at the middle
of tlie incision. The scalp incision was closed, except at the
middle, with a continuous silk suture. Loose iodoform packing
was introduced, forming a soit mass filling the cavity from the
surface of the brain to the level of the cutaneous surface. An
absorbent antiseptic dressing was Orlistat Lesofat Price applied, so arranged as to Buy Orlistat Cheap
exert but little compression. After the brain had been exposed
by the removal of so large an area of bone, the frontal portion
had settled down and back, leaving a remarkably large airs]>acc
between the brain, covered by pia, and the skull lined by dura.
On the evening of the same day the patient was able to utter
the first words spoken by him .since he had become uncou-
sciou.s, some hours alter the injuiy. At the end of a week he
was able to move his leg. and in three months Buy Orlistat 120mg to walk with the
aid of a stick. His right arm was now improved, hut ils action
was sluggish. The aphasie -ymptoms had steadily diminished
and the patient was constantly ac(]uiring new words, was row
able to converse, and had resumed his ]irofes?ional woi k, driving
his horse alone. His intellect was now absolutely clear. That
this improvement was to continue to the point of physiological
re-establishmtut of all the normal functions of the parts impli
cated in the ha-niorrhnge the speaker was unwilling lo assert,
but he did look for innch impiovement still to come, and be-
lieved Orlistat Slimming Tablets that the patient's chances Orlistat Otc were extremely good.
Dr. M. Allen Stark said that the case had seemed to liiin
specially interesting because of the possibility of making a
pretty positive diagnosis. If an ai)hasia was at first total, and
then partial recovery ensued, the possibiliiy arose ol the exist-
ence of subcortical leson or lesion in the course of the speech
tract between the third frontal convolution and the medulla.
But in this case the aphasia had remained total for tin ee nn^nths,
and hence it was thought that the lesion must be coitiial and
located in the posterior i)art of the third frontal gyrus. The
location of the paralysis pointed to the central convolutions in
their middle portion as the seat of the lesion. Another inter-
cBtin); feature in this case, which had served to throw light
upon a disputed point, was the fact that there had been through-
out a slight Orlistat Price In India degree of ana'sthesia in the paralyzed limbs. This
pointed to the acceptance Orlistat 120 Mg Price of the theory that the sensory and
motor areas in the cortex coincideil. The lesifin Cost Of Orlistat found thus
threw light on the localization of tin' tiii'lilo si use. The ^nc-
518

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