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January 5, 1889

" Deeper Brain Surgery."

JAMA. 1889;XII(1):33. doi:10.1001/jama.1889.02400780035011

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Dear Sir:  —With reference to your interesting comments on Dr. Keen's article in the Medical News advocating exploratory puncture and tapping of the cerebral ventricles, will you allow me to say this: The operation was, I believe, first suggested by Wernicke, and latterly again by Dr. Zenner, of Cincinnati.Last spring I had a patient upon whom I made a diagnosis of cerebellar tumor. The intense pain, rapid development of optic neuritis and other symptoms led me to think it probable that there was pressure on the venæ galeni and excess of fluid in the ventricles. The idea of tapping them occurred to me, but in talking over the subject with Dr. Weir he was inclined to discourage it, considering deep punctures of the brain far from safe. The patient died. A tumor was found involving nearly the whole of the left cerebellar hemisphere and part of the middle lobe.

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