Unmasking a Wicked Marquess: A

Historical Regency Romance Novel

Henrietta Harding
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Unmasking a Wicked Marquess
A REGENCY ROMANCE NOVEL

HENRIETTA HARDING
 Copyright © 2024 by Henrietta Harding

All Rights Reserved.

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 Table of Contents
Table of Contents
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Unmasking a Wicked Marquess
Introduction
Prologue
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Chapter 19
Chapter 20
Chapter 21
Chapter 22
Chapter 23
Chapter 24
Chapter 25
Chapter 26
Epilogue
An Earl's Christmas Seduction
Introduction
Chapter 1
Chapter 2
Chapter 3
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Unmasking a Wicked Marquess
 Introduction
Juliet has lived a life according to the rules, obeying her mother and father's expectations, until a meeting with a scandalous
stranger at a ball changes her life forever. His illicit kiss sets her on a path of rebellion leaving her yearning for more. Little
did she know, he is the wicked Marquess of Ashton, the son of her family's long-sworn enemy. As fate brings them together
once again, among Ascot’s fever, the old rivalry will start burning as hot as her untamed passion for the Marquess.

Can the fiery Juliet back away from the one man who has ever tempted her?

Edward, Marquess of Ashtonfreshly, has just returned from his travels in India. Having secured more horses for the king and
his father's races at Ascot, Edward feels alive with life and adventure. His frequent rule-bending during travels contrasts
sharply with the rigid world of the ton, leaving him restless and uneasy. Yet, his encounter with a masked beauty kindles a
desire for seduction. When he discovers Juliet's identity though, his spark only intensifies, defying the bitter history between
their families.

Will he succumb to the rules he has always resisted?

As Ascot approaches, Juliet and Edward navigate a world of secret trysts and hidden love. With false accusations, antagonists
and schemes behind closed doors, their flaming romance seems unattainable. Faced with accusations and their families’ feud,
they strive to defy societal expectations. Will Juliet and Edward defy the odds, or will the conspirators at Ascot succeed in
driving them apart?
 Prologue
Royal Ascot, England, 1798

“Robert? Philip? Are you two not watching? The race is about to begin.”

Robert pulled his attention away from where he was toasting with his friend, Philip Welton, the Duke of Lantham. They had
been laughing for so long that Robert couldn’t even remember how their discussion had begun, yet Philip was wiping tears
away from his eyes as Robert tried to stop himself from choking on his wine.

“You know the pair of them, dear,” Philip’s wife, Amelia, was saying with a laugh of her own. “Leave them to it. They’ll watch
the race when they’re good and ready.”

“I think our wives despair of us,” Robert said with a hearty chuckle, taking his friend’s shoulder and steering him away from
the carafes of wine towards the box that overlooked the racing field.

“You don’t say?” Philip laughed, shaking his head. “Amelia predicted it well enough. Whenever we’re together, we’re
incorrigible.”

“Soon enough, we won’t be able to get you apart,” Cecily, Robert’s wife, appeared at his side. He smiled when he looked at
her eyes – violet in colour. They were striking and so unique that he had never seen another woman with those eyes before. It
was one of the things he had first noticed about her, and since the day they had met, he had found himself growing more and
more in love with her.

Just a year ago, she had given birth to their first child, Juliet, and Robert was delighted that his good friend, Philip, had agreed
to be godfather.

“With your sister, Rob, and your brother, Philip, getting married, you’ll be in each other’s company constantly!” Cecily said
with a laugh. “On second thoughts, Amelia, I will take that drink.”

Amelia laughed and filled up the glass as they moved to the window of the box, laughing together.

“They’re right, you know,” Philip said, elbowing Robert. “We’ll be family soon.”

“Hmm. If you look at the pair of them, you’d think they were impatient for the wedding.” Robert pointed over his shoulder into
the far corner of the box, gesturing past others who were guests of the king in the royal corner of the racecourse. Through heads
dressed in fine hats and bodies clothed in smart suits, in the corner of the room, they could see Emily and Hugh together.

They sat calmly, talking to one another, perhaps even having forgotten that they were on a race day. Emily’s light-brown hair,
which was much like Robert’s own, was tucked up at the back of her head, curling softly. Her hand held Hugh’s tightly, and the
poor man seemed incapable of looking at anyone but Emily.

“Impatient? What gave you that idea?” Philip said with a wry tone as Hugh lifted Emily’s hand to his lips and kissed the back.
“I wonder.” Robert shook his head and turned back to face the window. “Cecily is right. The race is starting.” He gestured
forward beyond the open window down at the course.

The great lawn stretched out in front of them, dry and arid in the heat of the hot summer they had been enduring. Many of the
gentlemen gathered in the sun by the fences had shed their jackets in that heat, and the ladies had brought fans with them to
flutter in front of their faces. Above the many heads, with cheeks flushed red in the heat, people waved betting cards, either
eager to make their bets or wanting to claim their winnings.

At one side of the course, the horses were lined up, ready to start.

“Yours looks to be in fine condition,” Philip said with a begrudging pat on Robert’s shoulder. “No hard feelings if you win,
eh?”

“Same for you.” Robert nodded at the horses. “Neither of us cares about that commission to breed horses for the king, do we?”

“Not at all. Thought it might be useful,” Philip confessed with a small smile and a wink, the movement of his head making his
dark hair dance about his forehead. “Such a charter could be profitable indeed. So whichever of us wins it, or if indeed another
wins it, let us toast their success. Agreed?”

“Agreed.” Robert was all too happy to make this arrangement. He could not deny the royal charter would be useful for his
family as well. It would be a good advancement, and when his daughter was grown, maybe he could even introduce her at the
royal court if he could only move in the royal circles first.

“They’re starting,” Cecily said with excitement, clutching Robert’s arm. It was always the same; with any race they watched,
she held onto him tightly. He looked at her, feeling the warmth and love he had for her growing. “Oh, I do hope the animals will
be well. It pains me when they are hurt.”

“The horses are well trained, and the jockeys, too. They’ll be quiet safe,” Robert assured her, threading an arm around her
waist as the horses trotted into the starting blocks.

A general hush fell over the whole racecourse as a man stood at the side of the track, holding a pistol into the air.

Robert could hear his heartbeat in his ears as he stared at his horse. In stall number three, his horse, Midnight Dancer, was
raring to go. With a deep black coat, a long nose, and thick, strong legs, he was noticeable from a great distance away. Over the
last two years, Robert’s horses had been winning many races, and no other horse had won more than his prize stallion,
Midnight Dancer.

Come on. You can do it. Win me that commission.

Then the pistol fired, and the horses bolted out of the stalls.

“Look, look at them go,” Amelia called excitedly. Her hair, as dark as her husband’s, was braided at the back of her head and
now swung around as she jumped about with her excitement. “Oh, our two horses are ahead!”

Robert held his breath as Cecily beside him sent prayers to God to keep the two horses safe. It was true that Midnight Dancer
and Philip’s horse, Shadow, were neck and neck, striding out far ahead of the others.
“I don’t think I can watch this.” Philip turned away from the window.

“Are you mad?” Amelia cried and turned to her husband, taking his shoulders and forcing him back around to watch the race
again. “This has been the culmination of months of work.”

“Try years,” Robert muttered.

“Exactly.” Philip agreed with him. “It’s so close, I cannot watch.”

Suddenly, Midnight Dancer started to edge in front. It was by the smallest amount, his nose just stretching in front of the others.
The jockey rode him harder, raising himself with his knees, taking the brunt of the force of riding so fast. The stallion
responded and started to reach out in front of Shadow.

“Ah, it’s over.” Philip suddenly laughed. “Give my friend his money and his commission. He deserves it.”

“The race isn’t over yet,” Cecily reminded him.

Just as she said the words, they seemed to be an omen. The jockey shifted in the saddle as if he had nearly been thrown off, and
then Midnight Dancer bucked.

“Woah, what was that?” Robert muttered, starting to breathe again in short, shallow breaths.

Abruptly, the horse pulled up. Shadow struck out in front, riding ahead, and Midnight Dancer bucked and danced about the
course so much that those watching at the sides of the fences scurried back, taking refuge behind the betting stalls.

“He’s never done this before,” Cecily murmured. “What is wrong with him? He looks almost … possessed.”

Robert was not a superstitious fellow, but on this occasion, he was tempted to agree with his wife.

“What …” He didn’t finish the question. The horse rose back on its hind hooves and tipped the jockey clean out of his saddle.
“Thompson!” Robert cried in a sudden panic about the jockey’s safety.

Thompson was wise enough to roll away under the cover of the banner as Midnight Dancer struck out wildly in the air with his
front hooves. The other horses flew past him, galloping away after Shadow, and then the horse dropped down its hooves and
did a slow lope back in the wrong direction towards the stalls. He loped away, almost as if he was injured.

“Oh.” A breath escaped Cecily.

He knew what she was suffering. It was speechlessness, for he suffered the same thing.

As a roar went up from the crowd, Robert turned to see Philip and Amelia at his side. Neither one of them was celebrating, but
both were looking at Robert and Cecily.

“I’m so sorry,” Philip said, frowning. “I do not understand. He looked great around the parade ring just now.”
“Do not worry about it, my friend.” Robert cleared his throat and pushed away any grumblings he had about what had just taken
place. “You won the race, fair and square, and remember what we agreed.” He offered his hand to Philip. “I shall be delighted
for you. You will have the royal commission, and it will be going to no better man.”

“Thank you, Robert. That is very gracious of you indeed,” Philip said as he shook his hand.

Robert continued to smile, quite determined to be happy for his friend, even if the strange behaviour of his horse still niggled at
the back of his mind.

The moment they were done with the congratulations and Philip had to go and collect the prize for his horse, Robert left the
box, with Cecily hurrying behind him.

“Where are you going?” she cried, struggling to keep up with her hands reaching for the back of his waistcoat.

He ran to the stables as quickly as he could, where he found poor Thompson sitting against the wall of the stable yard. He
looked winded and repeatedly rubbed his back as he kicked off his riding boots.

“Are you all right? Shall I send for a physician?” Robert asked, hurrying to his jockey’s side.

“It is not me you should be concerned for, My Lord,” Thompson said with a heavy sigh. “I am quite well, but that …” He
jerked a thumb, pointing back into the stable. “I have never seen anything like it in all these years. Lady Clarence,” he
addressed Cecily directly. “I know your love for animals. I plead with you not to go in there now. It will only upset you.”

Yet Robert knew his wife. Her love for animals was only outweighed by a wish to do what was right. She ran into the stable
even before Robert could, and the gasp that escaped her made his heart tremble in his chest.

As he rounded the corner to his horse’s stalls, he saw Midnight Dancer on the floor, struggling on his side. He’d been tied with
his reins to a post, for a horse attendant was trying to still him to examine what appeared to be bloodied spots across his back.

“Wh-what is this?” Robert managed to stammer, his hands starting to shake with anger when he saw the pain his poor horse
was in.

The stable hand looked up, a grimace on his face as he wiped the sweat from his cheeks.

“It is sabotage, My Lord,” he said simply. “Someone fastened these pins to the seat of the saddle.” He took the saddle from its
discarded position at the side of the stable and turned it up. “He bore the pain for so long, but when the jockey drove him
harder, it was too much. Someone wanted to make sure Midnight Dancer could not win that race.”

***

“Lord Clarence? May I speak with you?”

Robert struggled to clear his mind. It was the morning after the foul race, and he was standing outside of Philip’s stable,
waiting for Philip to arrive so they could go riding together. Robert and his family were staying with Philip for a few nights,
and they had spent last night’s dinner going over everything that had happened to Midnight Dancer.
Philip had been horrified and urged Robert to engage a local constable to look into who might have committed the sabotage.

“My Lord?” the voice called to him again.

“My apologies, my mind was elsewhere.” Robert looked away from the cloudy sky that spelled imminent rain and turned to
face Philip’s stable hand, Wally. The young man was someone Robert had seen in passing a few times. A rather eager lad, he
was struggling to stand still now as he approached Robert rather nervously with his cap in his hand. “What is it?” Robert asked
him.

“I heard of what happened to your horse. I’m so sorry, My Lord, but I fear I have more bad news.” He looked at the ground
between them as if saying it was hard enough, but he could not look at Robert at the same time.

“I have to tell you something. I have to tell you that I saw a man going to your horse’s stalls and where the equipment was kept.
I know the man, and I know the Duke of Lantham pays him to do things. I fear he paid the man to sabotage your horse, so his
would win. So … so he could get the commission from the king.”

“You are mistaken,” Robert responded on gut instinct and shook his head.

Philip? No. Philip would never do this to me. He is a true friend.

“I am no liar, My Lord.” Wally looked up. The sudden power of those eyes boring into Robert’s made him pause. “I saw him,
as did others that I can bring to you to prove it to you.”

He believes it to be true and others saw it too.

“I know he feared your horse would win again. I overheard him talking to the duchess about such a thing, too.” Wally stepped
back. “I’m so sorry, My Lord. I thought it was right you knew.” With these words, he hurried away.

No, no. It’s not possible.

Robert stood for some time until the rain began, thinking about what he had heard. He didn’t want to believe it and refused
flatly, yet his mind kept working over it. He thought of the delight on Philip’s face when he came back to Robert, talking of how
he had spoken with the king about the royal commission.

Robert walked away from the stables. He went to the house and strode inside, where he found Philip in the entrance hall,
struggling to pull on his riding boots. Far behind him on the stairs was Amelia with her son beside her, holding his hand tightly.
Edward was the picture of his father, dark-haired and blue-eyed.

He watched his father, laughing at his ridiculous attempt to get the boots on. Behind Amelia was Cecily, with their baby
daughter in her arms. Juliet was just old enough to wave manically at Robert. Another time, he would have waved back at his
daughter, but he couldn’t.

“Ah, Robert. I’m so sorry I’m running late. I can’t get these damn things on,” Philip called, sinking onto the bottom step and
pulling the boot up to his knee.
“Don’t worry, it’s raining.” Robert’s cold tone alerted Philip to the fact something was wrong without him having to say any
more.

“What is it?” Philip asked, looking up from his boots. “Robert, what is wrong?”

“I just heard something. Something I do not want to believe.” He shook his head, his words creating an atmosphere around the
room. They all waited with bated breath, hanging onto his words. “Someone on this estate believes you, yes you, Philip, paid
another to bind that saddle to his back with pins.”

“Robert!” Cecily was outraged and covered their daughter’s ears, even though she couldn’t understand at her tender age.

“I am just repeating what has been said.” Robert stepped forward, needing to look his friend in the eye, needing to read the
truth.

Philip said nothing for a minute. A strange, eerie silence fell in the room, and then he stood slowly. Taller than Robert,
suddenly, Robert felt very small indeed. He could understand why Philip was so terrifying in business meetings when the
business partner had the misfortune to get on the wrong side of them. That expression was quite harrowing.

“You would dare to accuse me?”

“I am not accusing. I am repeating. Tell me it is not true, Philip.”

“I should not have to tell you it isn’t true. You are my friend, Robert. Do you honestly think I would do this to you?”

“I do not know what to think.” Robert felt sick. Why wouldn’t Philip just deny it? Why wouldn’t he just say, of course he had
not done it? The evasive answer made Robert begin to doubt his own knowledge.

Do I know my friend at all?

“You should know what to think!” Philip seethed and stepped towards him.

“Robert, please,” Cecily called from her position part way up the stairs. “These are our friends. We are staying in their house.”

“And my horse was sabotaged when we were racing for a royal commission,” Robert insisted, meeting his wife’s panicked
gaze.

“If this is jealousy at play, I will understand it and forgive it,” Philip said, his tone so calm that it infuriated Robert even more.
“But take back that accusation this moment.”

He still hasn’t said he did not do it.

Robert glared at his friend and blinked. It was as if he saw Philip in a new light, that hard frown unshakeable.

“Cecily, we’re leaving.”

“What?” she spluttered, stepping around Amelia and Edward and coming down the stairs. “Robert, pray, think about this.”

“No, no, by all means, go.” Philip waved a hand at the door. “I will not have someone in my house accusing me of doing
something … so foul. Get out, Robert.”

“Philip?” Amelia was the next one to cry out. “Calm yourself.”

“I will not be calmed. Did you hear what he said?”

Robert strode to the door and practically jumped off the steps in his eagerness to get out of that house.

“Robert? What are you thinking?” Cecily cried, running after him with Juliet in her arms who was now crying in alarm at the
loud noises. Robert took his daughter in his arms, soothing her with soft tones.

“I don’t know what to think,” Robert muttered. “But if I find nothing to dispute what I have just heard, then I have no choice but
to believe it, do I? It’s possible, Cecily, that Philip was never my friend at all.”
 Chapter 1
Nineteen Years Later, 1817

“Careful with those horses. I cannot tell you of what value they are,” Edward called to the stable hands as he jumped down
from his own horse. He landed with ease on the cobbled ground of the stable yard and shrugged off his tailcoat, heated on the
bright sunny day.

The stable hands looked abruptly more nervous about their charges, eying the Marwari horses with wariness. The animals
were rare from his travels to India. Sleek in build, lithe, athletic, and with uniquely pointing inward ears, Edward knew what a
fine gift one of these animals would make to the king. The other was for his family to keep.

“Here, they are soft-natured if you know how to treat them right.” Edward strode towards the nearest horse and stroked him
down the nose, humming softly in his ear. At once, the horse that had appeared to have a wild temper before softened and
nuzzled his hand. “Good boy,” he whispered for only the horse to hear.

“We’ll look after them, My Lord,” called the familiar voice of the stable manager. A larger and burly bloke, he stepped
forward with his wizened face beaming in a smile and bowed to Edward. “It is good to see you have returned from your
travels.”

“Thank you, Bernard. It is good to see you too. I shall have to tell you all about what I saw some time.”

“I look forward to it.” Bernard waved his hat in farewell and went to help with the horses as Edward left the stable yard with a
spring in his step.

For too long, he had been gone. First, there was the university in Oxford, then his travels, focusing most particularly on India
and the continent. Now he was back and had sent his luggage ahead, he was impatient to see his family again.

He strode up the front porch steps towards the wide, red-bricked building, but before he could take hold of the door handle, the
door itself was flung open inward, and a shock of dark hair flew at Edward.

He yelped and jumped back in surprise, for one minute thinking his father had bought a tall greyhound in his absence. There
was raucous laughter from inside the house as Edward caught the unmistakable figure of his sister.

“Jane!” he shouted, catching her safely before they could tumble down the front steps together. “Oomph, you could have killed
us then.”

“You’re home, you’re home,” Jane cried repeatedly, jumping up and down as she released him. Just reaching his shoulders, he
could see she was much taller than when he had last seen her. Her dark hair was unmistakable, for it was the same black sheen
they all possessed, him, his father, and his mother. As he peered past his sister and into the entrance hall, he saw both of his
parents looked a little grayer than last time.

“There you are.” Philip opened his arms out wide, and Edward gladly walked towards his father, embracing him tightly.
“Beware of your mother,” he whispered in Edward’s ear.
“What?”

“I do not think she intends to release you again.”

Edward discovered how right his father was. Embraced by Amelia, he was quickly told off for not writing more and for
sending his luggage ahead as she had been so excited that morning when she had mistaken his luggage for his return. She kept
holding onto his waist, clinging to him, as Philip and Jane led their way into the drawing room.

“Come, we’ll start the tea,” Jane said to their father. “They can have some when Ma dares to release him.”

“You should have come home sooner,” Amelia whispered, showing no sign of releasing him.

“Missed you too, Mother.” He held her back and patted her on the shoulder, then urged her to release him a bit so he could look
at her face. There were a few more grays in her hair, and her face bore a few more wrinkles than before, but the most
noticeable thing was the unshed tears in her eyes that she was holding back. “What is it?”

“Happy tears.” She waved a hand at her face dismissively. “Someday, you will have a child of your own, and you will
understand how hard it is not to see one of them for so long.” She embraced him again, and he chuckled, holding her back
before they walked together into the drawing room.

“Hurrah!” Philip declared and clapped his hands together. “You have released him. Quick, get a drink, my boy, before she
embraces you again.”

Edward used the back of the settee to shift himself over and sit beside his father. The athletic, if informal, movement made his
mother tut as his father chuckled, passing him a teacup.

They started with Edward’s news, and he told them of the new rare horses he had brought back and some of his travels, though
he promised more tales in time.

“I’m too tired for more stories.” He slumped into his seat rather dramatically, earning another reproachful tut from Amelia.
“Jane, you tell stories for a while so I can take a break and drink my tea.”

“Very well.” She put her teacup in her saucer and sat tall so the fading light of the day through the windows shimmered off her
dark hair, and then she abruptly smiled broadly. “I have news for you, brother. News that we did not put in our last letters.”

“Oh? What is that?” Edward took a mouthful of tea.

“I am to be married.”

Edward choked on the tea so aggressively that his father actually slapped him across the back.

“Oomph! Dear God, your strength isn’t failing you, is it?” Edward jested, rubbing his sore back in surprise.

“I’m not that old yet.” Philip elbowed him.

“Why so shocked?” Jane was now on her feet, her hands on her hips. “Am I so disgusting I could not find someone to marry?”

“Forgive me my surprise, sister,” Edward explained, now wiping his mouth with a handkerchief that his mother produced from
where it had been neatly tucked under the sleeve of her gown. “When I left, you said you would never marry. You were quite
intent on that.”

“Oh, well.” She sat down, now all smiley once again, her spine softening. “That was before I met Fred.”

“Fred? He has a name, then. Anything else I should know about him?”

“Lord Frederik Winter, a baron,” Amelia explained with something of a sigh of wistfulness. “Oh, he’s a handsome fellow
indeed. He suits her very well.”

“He’ll pay for her very well, too,” Philip muttered, pulling a laugh from Edward.

“You checked, did you?” Edward asked his father.

“I wasn’t going to let your sister go to any man that didn’t have a good estate.” Philip shook his head as he laid back on the
settee, resting as he sipped his tea. “It’s important to me to see you both settled. Speaking of which …” He trailed off and
curved a single eyebrow at Edward.

“What? No. No.” Edward shook his head, aware out of the corner of his eye that Jane was struggling to hold back her giggle
behind cupped hands. “You’re not helping,” he added in her direction.

“Cake?” she asked sweetly, offering up the sponge cake from the tea tray that smelled distinctly sugary and full of strawberries.

“You know what’s coming as well as I,” Edward observed.

Amelia suddenly reached forward from her armchair and took hold of Edward’s shoulder.

“Ouch,” Edward winced for the second time in as many minutes. “Since when did your hands get like birds’ claws, Mother?”

“It is time you married,” she said with full heart. “Choose a good woman, someone who will make you happy,” she added with
that wistful tone once again.

“Someone with a good dowry,” Philip added matter-of-factly.

“So romantic,” Jane tutted at their father.

“One of us has to be practical.”

“Then let it be me,” Edward piped up. “I do not have to get married yet. There is plenty of time for all of that.”
Edward’s mind was suddenly full of pictures and memories of ladies shifting gowns from their shoulders and of beds with the
sheets ruffled and dropped to the floor. On the continent, he had not been as well-behaved as perhaps his parents thought. When
attending parties and masked balls in Italy and India, there had been a general air of temptation and scandal.

At some of the darker, more mysterious parties, it had not been unusual to see an unwed couple kissing in plain sight in
corridors. What Edward had got up to at night to gain his first few experiences of lovemaking was for his mind only to know.

What he did know was that after enjoying himself for the last few years, he was in no hurry to choose just one woman yet.

“Yet you stand a better chance of having many babies if you get married when you’re young and if you have a young bride too.
You’ll have the energy for the necessities then.”

“Mother!” Edward cried in outrage, nearly dropping what was left of his tea in his teacup.

“What?” Amelia looked around in innocence as Philip and Jane started laughing once more.

“This has escalated fast,” Edward observed. “This conversation went from you telling me to produce an heir to having many
children. Many?” he repeated in an incredulous tone.

“It is necessary,” Amelia explained with a shrug, reaching calmly for one of the pieces of cake Jane was now offering up.

“Necessary?” Edward was stuck just repeating other words now, unable to form his own thoughts.

“Yes, necessary,” Amelia said simply with a nod.

Edward looked at his sister, tongue-tied.

“I blame you for this,” he managed after a minute of silence, pointing at her.

“Me?” She offered the perfect innocent look.

“If you weren’t getting married, this conversation wouldn’t be happening.”

“The time has come, Edward.” Philip clapped him on the back again, softer this time as he did it only to have his attention.
“Now you are back, have seen the world, and are doing so well in your business affairs, not to mention the horses,” he added
with a smile, making the wrinkles around his lips deepen, “it is time to turn your attention to the other part of your life. This
season, you should look for a wife.”

“God’s wounds.” Edward fell back on the rococo settee. “I should have stayed in India.”

“I am glad you did not.” Amelia looked at him and flicked her fingers. “And sit up. You won’t catch a wife slouching like that.”

“I’m not hoping to catch one.” He slouched down purposefully a little further. “You speak as if you go fishing for a lady. I
hardly imagine that is how you two courted.” Edward glanced between his mother and father. The two of them shared a little
smile, and when Philip winked at his wife, Edward looked away, groaning loudly as Jane giggled.

“Is marriage so quickly really so important? On my travels, events were not so strict and formal. They were more fun, much
more relaxed. I confess, I loved it. Very much.”

“Then find someone who doesn’t mind a man slouching on his settee,” Amelia said with her lips curving up into a smile. “Yet
you must still find someone.”

“But –” Edward didn’t get a chance to say any more.

“There is a ball in two days’ time,” she continued. “You shall attend, and there you can meet the ladies of the ton. You can see
which one takes your fancy.”

“I am not picking a horse, Mother,” Edward said calmly, at which point his father laughed broadly once more.

“You will be there,” Amelia said simply, holding his gaze. “Besides, it is right we introduce you to society again now that you
have returned.”

“You can also meet Fred.” Jane sat forward, offering up the cake once more. Rather eager to say or think of anything else other
than a hurried marriage, Edward snatched up the cake and took a rather large bite. Jane giggled as if she could sense his
thoughts, but his mother just continued to talk.

“Yes, it will be lovely,” she said, sighing with contentment. “Both of my children married by the end of the summer.”

That fast?

“Summer!?” When Edward choked for the second time, his father was even quicker with the slap to his back.

***

“What do you think?” Violet gushed and pushed open the double doors.

To Juliet’s mind, it was as if someone had sprinkled the entire mansion in glitter or some magical dust. With the strong sunlight
of the morning gleaming through the windows, every surface shone and glowed. Juliet turned her head back and forth, looking
around the entrance hall in pure bemusement.

Atop a myriad of white alabaster plinths, there were marble busts of great philosophers and thinkers, some even politicians.
Behind these plinths were great swathes of red cloth, hiding the entrances to other corridors. The floor was made of a rich pink
marble, and the great staircase that stood at the far end of the room, four times as wide as most staircases, was lined with a red
carpet, the balustrade gilded in gold.

“Only you, Violet,” Juliet said, releasing a breath with a giggle.

“Only me, what?” Her sister turned with an apparent look of innocence, though her hands reached for her hips warily.
“Only you would end up with a house so elaborate as this. You have always been fond of anything ornamental, have you not?”
Juliet said with humour and took her sister’s hands from her hips, using them to turn Violet around in a happy circle. “Look at
you now.”

She nodded at the vast ivory gown Violet wore and the many jewels that glittered at her throat and hung like teardrops from her
ears. “I do not think I have ever seen you so happy. Married life plainly suits you.”

“Oh, it does.” Violet finished her spin on her own and giggled behind a cupped hand. “My husband is very sweet indeed, and
he is always buying me things. Though between you and me,” she caught Juliet’s hand and pulled her so close that they bumped
shoulders, clearly in the effort not to be overheard by any staff that might be passing, “he gives me other things, too. Things that
make me blush and oh …” She released a pleasant shudder.

“Good God, Vi,” Juliet murmured in amazement. “You would think the marriage bed a wondrous thing.”

“Wait until you see what it is like.” Violet winked. “Believe me, it is.”

Juliet bit her lip. Never had she been curious about what sharing her bed with a man would be like until this moment. Seeing
Violet practically shuddering with excitement and a blush creeping up her cheeks so that she was the colour of a beetroot
betrayed much.

“We must simply get you married next.” Violet took her hand and pulled her through the house towards the staircase.

“Me? I am not in a hurry to be married. Believe me, if it is going to make me blush like that and offer wistful sighs to everyone
who passes me by, I’m quite happy without it.”

“That is not what I am like!” Violet protested halfway up the stairs.

“You are,” Juliet murmured. “I’m quite content on my own for now.” Yet, there was a part of Juliet that simply did not want to
talk about this. She was the elder sister and, technically, should have been the one to marry first, but life hadn’t worked out that
way.

Violet had met her husband, Lord Brandon Boulder, a viscount, and she had fallen madly in love. Within a few months, it was
obvious the feeling was mutual as the two scarcely spent a minute apart from one another at any event in the ton.

Juliet had been dragged to every part of London, to the races, sailing regattas, the theatre, Somerset House, even concerts
where she thought the violin music sounded more like cats screeching than any true instrument, for Violet and her suitor hadn’t
been to these events for what they were, but to see each other. Juliet had been their chaperone.

“Where are you taking me?” Juliet said, trying to resist her sister, who dragged her up the stairs.

“To talk of the masquerade ball,” Violet declared with eagerness. They reached a bedchamber on the top floor, and Juliet
giggled when she saw the sight. Just like any other room in this house, it sparkled and was full of ornaments.

The bedframe had been painted a brilliant white, the vanity table glittered with jewels, and there was a rather vast settee where
the cushions looked suspiciously mussed. As Violet walked in, she replaced the cushions on the settee, blushing purple once
again.
Juliet bit her lip, trying not to laugh when she saw her sister’s actions.

“You really are enjoying your new husband’s company if you cannot even make it to the bed,” Juliet said with a laugh.

“You and that witty tongue of yours.” Violet waved a mad hand in the air. “You know what mother would say of you talking of
such things.”

“She thinks them too, even if she does not say them. I know that.” Juliet knew deep down she had got her loose tongue from her
mother, for Cecily would frequently smile as she reprimanded Juliet for speaking so openly.

“Now, here is what I wished to show you.” Violet reached for the vanity table and pushed aside the jewels, opening a rich navy
velvet box from which she pulled out a glittering ivory mask. “Here. For you to wear at the next ball.”

“For me?” Juliet stepped forward in surprise. “Is this not yours to wear?”

“I do not need it. I shall be wearing something else, and if you intend to wear that beautiful white gown of yours, the one with
the sage green hem, then this shall be perfect.” She placed the mask onto Juliet’s face before she could object any further.
“There, you shall be the belle of the ball.”

“I have no desire to be the belle of any ball.” Juliet scoffed at the idea. “I simply wish to enjoy myself.” She pulled the mask
down from her face.

“Oh.” Violet looked quite upset at the idea. “But how else are you supposed to get married?”

“Vi!” Juliet laughed loudly. “I do not remember saying I intended to get married.”

Yet Violet cocked a single eyebrow. Plainly, she did not believe a word Juliet had said.
 Chapter 2
“Are you sure you will not come?” Juliet asked as she stood fidgeting in the doorway of her house. The white mask had been
tied neatly at the back of her head, her white and green gown covered by a slim-fitting pelisse. As she looked in the mirror, she
chewed her lip, not convinced by her appearance.

To her mind, Violet had always been the most beautiful of the two of them. Where Juliet had auburn hair, to such a degree that
the red tinge was something she disliked intently, Violet had fair blonde hair. They had a similar facial structure, with the same
heart-shaped faces and curved cheeks, but Juliet had always preferred Violet’s eyes.

She bore the rich brown eyes of their father, soft and almost puppy-like in their sweetness. In contrast, Juliet’s eyes were a
strange violet hue. Sometimes one had to strain to see it, squinting to look at her, but other times they glowed this unnatural
colour in the candlelight, and people would comment on the oddity of it.

Juliet adjusted the mask on her face, hoping it would help to hide that colour tonight.

“No, no. Gone are the days when the pair of us went to such balls.” Cecily appeared behind her, lovingly placing her hands on
Juliet’s shoulders. “We were young once and danced happily at such events. There were nights where your father and I were
scarcely ever off the dancefloor.” She giggled warmly. “Yet not anymore.”

“My knees couldn’t take it!” Robert called humorously from the other end of the room. “Especially the way you and I used to
dance.”

“He’s quite right.” Cecily continued to pat Juliet’s shoulder. “You are not worried, are you? Brandon will be a very good
escort to you and your sister. He is so protective of her; he wouldn’t dare be anything else.”

“I know.” Juliet sighed deeply. “You must know as well as I, Ma, they are so recently married they shall spend all evening
talking to one another.”

“Good,” Robert called once more from the other end of the room. “That leaves you to do your own thing tonight. Find a suitor
of your own. Dance with who you wish to, within reason, of course.”

“Pa!” Juliet complained and turned away from the mirror. Her mother fussed with her pelisse for a few minutes, adjusting it on
her shoulders with eagerness.

“All I’m saying is do not dance with every man that asks you.” Robert was sitting near the front door, rubbing one of his sore
knees. He’d injured them in a riding accident many years ago, and he sometimes walked with a cane to assist him these days,
though to Juliet’s mind, he still looked too young to walk with a stick. “Not every man is worthy of you.”

“He’s your father,” Cecily reminded her. “It’s his place to worry for you.”

“How am I to know who I should dance with?” Juliet asked. “Should I ask for the man’s credentials and a detailed description
of his reputation before I consent to dance with him?”
“It’s hardly the worst idea in the world.”

“Robert,” Cecily hissed and walked over to him. “Do not be ridiculous. We want Juliet to enjoy herself tonight.”

“Yes, yes, indeed we do.” Robert stood, reaching for the cane beside him and using it to walk nearer to Juliet. “Do enjoy
yourself, and as for your sister’s preoccupation with her new husband, do not worry about that.” He smiled indulgently. “We
can tease you too when all you can think about is the man you will someday marry.”

“Why is everyone preoccupied with me marrying all of a sudden?” Juliet asked, her voice a little sharper than she meant it to
be. Her mother and father exchanged a look, but neither of them said anything.

There was a knock on the front door, and all three of them turned to look at it.

“You were saved from answering,” Juliet murmured as she walked to the door and opened it wide.

On the doorstep stood Violet and Brandon together. They were looking at one another with such fixed stares that it took them
both a few seconds to realize Juliet had answered the door at all.

“Good evening,” Juliet said pointedly to get their attention, even going so far as to wave her hand madly in the air.

“Good evening.” Brandon turned to face her. His fair hair, only a few shades darker than Violet’s, flicked around his forehead
as he turned to look at her. “Well, the carriage is ready if you are prepared to depart, Juliet.”

“I am indeed,” Juliet murmured. “As ready as a bee is to sting.”

“Juliet,” Cecily hissed in reprimand, though, as usual, she was doing her best to hide her smile. “Behave tonight.”

“When do I do anything but?” Juliet asked with innocence. “You must allow me a few jokes at their expense.” She gestured
between Brandon and Violet, who were already walking back to their carriage, arm in arm, and laughing about something
together. “I feel like a third horse attached to a carriage when there should be just two, out of place and unlikely to upset the
cart altogether.”

“Nonsense.” Cecily waved a hand in the air. “Now go, go.” Juliet stepped outside, hurried by her mother’s quick flicks of her
hands. “And remember to have a good time!”

“Oh yes, I may have forgotten otherwise,” Juliet whispered, though she was the only one who heard this particular jest as she
followed her sister into the carriage.

Sitting on the bench opposite Violet and Brandon, they waved at her parents through the window as the carriage set off and
jolted from side to side, rolling calmly away down the road. This early in spring, the evenings were still not bright, so they left
in darkness with a single lantern overhead, swinging from side to side with the flame casting orange streaks across their faces.

“Well, are you looking forward to the ball tonight, Juliet?” Brandon asked, clearly attempting to shift his focus away from his
new wife.
“I can barely contain my excitement.” Her sarcasm seemed lost on Brandon, though Violet tutted at her.

“It shall be a good evening,” Violet insisted. “You shall see.”

“I wonder if you are right about that. You see, I have always wondered about the nature of a masked ball.” She untied the
ribbon from the back of her head and lowered the mask in her grasp so she could take a better look at it. “I wonder what the
true purpose of such an event really is.”

“How do you mean?” Violet asked though she was already leaning on her husband, their hands clasped tightly together, her
attention slipping away.

“Well, to choose to hold a masquerade ball, you must have one of two intentions. Either you have some misdeed you wish to
hide in plain sight by concealing your own identity, or you are quite bored, and you enjoy the idea of everyone else’s confusion
and their own misdeeds done under a mask.”

“Ha! You are such a cynic, Juliet,” Violet said with a rich laugh. “Perhaps our hosts were simply hoping to have a good time.”

“Perhaps,” Juliet murmured, but she was not so convinced. As she tied her mask to the back of her head again, she saw a
problem with the request her father had made of her. In his wish for her to dance with only reputable men, he had quite
forgotten the fact every man there tonight would be wearing a mask.

Plainly, I shall have to ask any dance partner to remove his mask first if I am to please my father!

***

“Dear God, is this what classes as fun in the ton now?” Edward muttered in his sister’s ear as he escorted her into the
masquerade ball. Everywhere he looked in the great hall, he was reminded of a performance. It was as if every guest wore a
persona in their disguise and had not bothered to come as their true self.

Some ladies wore that much jewellery, it was impossible to see their true skin, and other ladies had such feathers thrust into
their hair that their hair was impossible to discern. Even some of the gentlemen looked just as ridiculous to Edward’s mind,
with dandies bearing ostentatiously laced cuffs and collars and some even wearing the thick white wigs that had been
considered fashionable in the last century.

Edward’s mouth hung open in wonder as he and Jane walked further into the ballroom. The more he looked, the more he
observed people’s behaviour.

Gentlemen stood rigidly as if pokers had been shoved up their backs, and ladies fluttered fans in most particular places,
perhaps making specific gestures to mean certain things, as per the language of fans, and other times just trying to draw their
suitors’ attention to the curves of their breasts or the flattering line of their gowns. Not one lady fluttered her face with a fan as
if she were truly suffering in the humidity of the room.

“Calm yourself. You promised our mother you would behave,” Jane whispered.

“Did I?” At Edward’s tone of defiance, she stood subtly on his toe. “Ouch, what was that for?”
“You are here tonight to meet my betrothed and to find one of your own.”

“Don’t you start sounding like our mother.”

“You must behave tonight,” she whispered and lifted her own fan, opening it wide to flutter it in the air quickly like the wings
of a butterfly. Fortunately, she raised it to cover her lips so she could whisper to him conspiratorially, “All jests aside, and our
parents’ wishes aside too, you cannot be completely against the idea of marriage, surely? A female companion, so you are not
lonely anymore?”

“I do not remember saying I was lonely. I’m quite comfortable in my own company.” His shrug made her close up the fan and
tap him around the arm with it in reprimand. “Ow.” He pretended to be hurt, wincing and rubbing the top of his arm. “Just so I
know, how many more injuries should I expect tonight?”

“Surely tonight, brother is a chance for you to meet ladies without our parents breathing down your neck.”

She nodded at the great room and the number of ladies wandering back and forth. Edward had to admit there was a significant
number, so many in fact that the gowns and headdresses started to blur together. He saw some ladies smile in his direction, and
others started waving at gentlemen with their fans, pointing at the dance floor most eagerly in the hope of getting an invitation to
dance.

“How can one truly get to know a lady when you cannot even see her face?” Edward pointed out, his eyes resting on the masks
on their faces. Some masks were slim things that barely hid an identity at all, but other ladies had gone to more effort. They’d
hidden their hair under turbans and wore masks that covered three-quarters of their face so they would not be recognized.

“Edward.” Jane rounded on him.

“What did I say wrong?”

“Do you mean to tell me that you are truly so shallow you must see a lady’s face before you decide whether you like her or not?
Is beauty all you think of? There is more to finding a companion in life.”

“Calm your blood, Jane.” Edward laughed at his sister’s reaction and the growing pinkness up her neck, a sign of her outrage.
Fortunately, the mask covered so much of her face it wasn’t easy to see the blush on her cheeks. “Come off it. I am not so
shallow as to think beauty is all that matters, but I am also a man of the world. To find a partner, to consider marrying them, one
must at least be a little attracted, must they not?”

“Whether or not your spouse has a fair face should not be important. It’s what’s in here that counts.” She tapped her own heart
with her closed-up fan. “Oh, oh. Here he comes!” She stepped excitedly to the side as a young man was hurrying towards them.

He had a mask in his hand and was evidently fumbling with the difficulty of tying the mask around the back of his head. His
face, fully visible, revealed strong lines with a handsome jaw.

“It’s Freddie,” Jane whispered to Edward in a rushed tone. The loose dark brown locks hung around the man’s ears, and the cut
of his suit sat neatly upon his shoulders. Jane bobbed on her toes, waving at him. When he saw her, he clearly recognized her at
once and hurried over.
“What was that you said about a fair face not being important in a spouse?” Edward asked pointedly. “Do you not take your
own advice, sister?”

“Do you want hitting again?” She threatened him with the fan, but he was fortunately saved by Freddie appearing at their side.
“Ah, Freddie.”

He greeted her hurriedly, fumbling so much that he dropped the mask. He revealed himself to be a clumsy fellow, though
Edward couldn’t knock the man’s eagerness to see Jane.

“I am glad to find you,” he said in a hushed tone, kissing the back of Jane’s hand and offering a kind smile. “You’re going to
have to help me, Jane. I am making an exhibition of myself as usual.”

Edward bent down and picked up the mask for him. “Ah, thank you,” he said, taking the mask back.

“Freddie, meet my brother.” Jane gestured between them. “He has just returned from his travels to India.”

“It is a pleasure to meet you, My Lord.” Freddie bowed in greeting. “I have heard so much about you from the family.”

“It is good to meet you, too.” Edward could see, though, that Freddie’s attention was already slipping back to Jane. Edward
was actually relieved by this eventuality. For one thing, he didn’t have to stand here stiffly and make an awkward conversation
with a man he didn’t know, and the fact Freddie was so keen on talking to Jane was a testament to his affection for her. “We can
talk another time, but I can see you two are longing to dance tonight.”

“A dance? Oh yes, let’s Freddie.”

“Of course, though, as usual, you will have to forgive my two left feet.” Freddie tried to put on his mask but struggled once
more. Fortunately, Jane took it out of his hand and did it for him.

Edward waved them off and left the pair of them to dance. For a few seconds, he watched them walk across the room in the
direction of the dance floor. Freddie stared at Jane with such intensity that Edward was struggling not to laugh.

You would think the man had been put under some spell or trance. I cannot imagine ever looking at a woman in that way!

Edward walked away and headed towards the refreshments table. Over his shoulder, he could now see people glancing his
way, clearly curious about his identity as he had been seen standing beside Freddie, who hadn’t had his mask on at the time.
Naturally, the normal rumour mill of the ton was in place, and they were all speculating as to who was keeping Lord Frederick
Winter company.

Edward glanced at some of the ladies who were now whispering behind fans. He felt rather like a tiger being hunted in the
depths of the Indian forests, not looked at so much for who it was but what it was. Some ladies in front of him stepped in his
way.

They fluttered their fans in front of their deep necklines, plainly hoping for an introduction, but Edward was fortunately saved
from such an opportunity as their hunt drew in two other men who approached the group.
Edward chuckled under his breath as he reached the refreshments table. Before he could reach for a glass of claret to quench
his thirst, someone bumped into his arm. A splash of cold liquid tipped down his tailcoat arm, and he looked down, seeing the
bubbling liquid spill everywhere. It may have been lemonade or champagne; he wasn’t sure.

“What the …” he murmured and looked up, ready to accost who had ever bumped into him. Was this someone else’s attempt to
get an introduction from him?

“I am so sorry.” The lady before him immediately put down her glass and offered up a handkerchief. “I was trying to escape
someone.” She waved a hand madly over her shoulder, and Edward saw a rather eager-looking gentleman standing at a
distance who had evidently wanted her attention. “Serves me right for not looking where I am going.”

“It is nothing,” Edward said, aware that she didn’t seem to pay attention to his words. She mopped up the spill she had made
on his jacket, her slim hands working quickly down his arm, touching him as if they knew one another.

For the first time, Edward looked at the lady. Her elegant fingers, covered in white gloves, led up to slender shoulders with an
open neckline, revealing the delicate collarbone. She did not wear excessive jewellery but a single silver stone at her throat.
Her white and green gown flattered the slim curves of her figure, and to his dismay, Edward found his eyes tarrying longer than
they should have done on the curve of her waist.

“I think you have got it all,” he said with a soft laugh as she finished mopping him up and lifted her head.

Edward felt his breath halt in his throat. She had tipped back her head, the curls of her auburn hair falling behind her ears to
reveal her face. Most of it was covered by an extensive white mask, but what had captured him was the colour of her eyes,
unmistakable in this candlelight. They were an unusual almost gray, but more purple hue. Quite stunning, Edward couldn’t stop
staring at them.

“Lost for words, sir?” she asked, her lips turning up into the smallest of smiles.
 Chapter 3
It was as if the gentleman before her had been struck.

Juliet smiled as the gentlemen laughed at her words and shook his head.

“Forgive me,” he muttered. Yet his eyes didn’t stray far away. If anything, they looked down at her gown again, then back at her
eyes.

Oh.

Juliet gasped at that look. Never could she remember being looked at in such a way before. Once again, it was as if he were
tongue-tied, unable to say a word as he stared at her.

“Permit me to hazard a guess,” she whispered. “Is it the odd eyes that have performed this magic?” She gestured to him with
the cloth she had just used to mop up her spilt drink.

“Odd? Well, I would not have called them that. There are a number of things that have now rendered me speechless, but it
seems as if every single one of them hardly flatter me; let us start again.” He turned to face her fully and offered his hand. “It is
a pleasure to meet you.”

He didn’t say his name. Curiosity burned within Juliet to know who this masked man was. His dark hair, wild and very short,
with just a few loose curls about his ears was tempting. She had an errant daydream about running her hands through those
curls, wondering what it would be like. His eyes, beyond a mask as black as his suit, were an almost shocking blue, so bright it
was as if she stared at a morning sky.

“And you,” she whispered, giving him her hand. As was customary, he bowed to her, bending over their hands, which were
now softly clasped together. His fingers, curling softly around her own, didn’t release her at once, and neither did Juliet pull
back from him. She was all too aware as he bowed to her that he held her gaze, never once looking away.

She took in as much of his face as she could judge beyond that mask. There was a strong jawline and the tiniest bit of black
stubble. Most men in the room were clean-shaven, but the rather more rugged appearance beneath that black mask, the
informality of it, had her mouth dry.

He stood straight, and they continued to stare at one another, neither of them saying anything for a minute or so.

“Well, do you think we have completed our impression of soundless statues for the night?” he asked her, his words breaking
her inability to speak. She laughed and shook her head.

“I think so. Shall we put it down to the effect of the masks, do you think?”

“We could say that or something else entirely.” He still hadn’t released her hand, and they just stood there together, holding
hands in the most uncustomary way, though still, she didn’t pull back. There was a warmth in that touch, a softness that seemed
to contrast the keenness of his stare so much that she didn’t know what to make of him. “You said you were escaping someone
when you bumped into me?”

“I was.” She glanced over her shoulder again, rather glad to see that the man who had been persistently trying to ask her to
dance had at last given up. “I am afraid I was quite desperate for an escape.”

“Then allow me to offer you another.” He shifted his hand from hers and travelled it up her wrist. The delicate brush of his
fingers on her gloved wrist made her tremble with a sort of thrill she had not known before. He opened the dance card, slung
loosely around her hand, and angled his head, looking at the lines written within.

“No partner for the next dance?” he asked, his voice soft. “Care to allow me to fill that space?” He moved his hand to hers
again, soft, giving her every chance to escape if she wished to.

Wordlessly, she nodded and allowed him to escort her away.

They moved from the drinks table through the crowds and towards the main dance floor, where they waited for the last dancers
to finish their cotillion. All left the floor, and new people took their places, with the pair of them included. They moved to the
very middle, where the masked gentleman turned to face her with a small smile lifting his features.

“I should mention,” he whispered, bending so close to her that she could practically feel his lips brushing her ear.

What is happening?

She swallowed, struggling to get past the perpetual dryness in her throat.

“It has been some years since I have danced in the ton, for I have been travelling. I may not remember all the steps.”

“Then I am privileged indeed,” she whispered playfully. “Your first dance on your return? And I treated you so awfully by
throwing a drink at you.”

He laughed warmly. Before they could say any more to one another, the music began.

He stepped back, the distance between them increasing enough to allow them to bow and curtsy to one another. The whole
time, Juliet felt his eyes upon her as if he couldn’t bear to look away. When she stood straight from her curtsy, she heard the
opening notes of a quadrille. The music consisted of deep low notes, the violins and bass struck with great fervour as the
dramatic piece filled the ballroom air.

Walking towards one another, the pair circled each other, not a touch between them, though strangely, Juliet itched to hold his
hand, for there to be some connection between them. They halted, having now switched places, and looked one another in the
eye as the couple to her left now walked around them.

“We should probably have some conversation between us, should we not?” he whispered to her. “Otherwise, it seems you and
I are likely to continue to stare at one another in such a way for this whole dance.”

She smiled indulgently, amused by his words.

Another random document with
no related content on Scribd:
of lesion causing this symptom, some of which have been
reproduced in our table. We will not go into any details as to the
character of this symptom, referring the reader to the sources
indicated. In the first case given in our table (Case 10) the
hemianopsia was produced by a tumor in front of, and impinging
upon, the optic chiasm; in the other four cases (Cases 40, 41, 42,
and 43) the tumor was situated in the occipital lobe, and was
surrounded by an area of destroyed tissue. Hemianopsia is not,
strictly speaking, a symptom of brain tumor, but is likely to be present
in cases occurring in certain regions of the brain. Starr's conclusions
with reference to lateral homonymous hemianopsia when it is not
produced by a lesion of one optic tract are that it may result from a
lesion situated either (1) in the pulvinar of one optic thalamus; (2) in
the posterior part of one interior capsule or its radiation backward
toward the occipital lobe; (3) in the medullary portion of the occipital
lobe; or (4) in the cortex of one occipital lobe. The conclusions of
Seguin are only different in so far as they more closely limit the
position of the lesion.
25 Vol. IV.

26 Pp. 84, 85 of present Volume.

27 Amer. Journ. Med. Sci., N. S., vol. lxxxvii., January, 1884, p. 65.

Phosphenes, or subjective sensations of light, occur in various forms

—simply flashes or sheets of light, scintillations, balls of fire, etc.
They are not very common as isolated phenomena, and probably
are dependent in most cases upon irritation of the nerve and retina in
some of the stages of neuro-retinitis. Even visual hallucinations are
occasionally present, as in one of Bennett's cases of tumor of the
Rolandic region.

Conjugate deviation of the eyes, with rotation of the head, a

symptom of the early stages of apoplectic attacks, is also sometimes
observed in brain tumor. The patient is found with both eyes turned
to one side and slightly upward, as if looking over one or the other
shoulder, the head and neck being usually rotated in the same
direction. Sometimes the deviation is slight, sometimes it is marked.
Frequently the muscles of the neck on one side are rigid. The eyes
are commonly motionless, but occasionally exhibit oscillations. This
sign, well known to neurologists, usually disappears in cases of
apoplexy in a few hours or days, although it occasionally persists for
a long time. It will be more fully considered under Local Diagnosis.

Diminution or loss of hearing, tinnitus, and hyperæsthesia of hearing

are all occasionally observed. The most decided disturbances of this
sense are those which are found in connection with tumors of the
base or of the cerebellum in such a position as to involve the
auditory nerve or auditory tracts. Tinnitus, acoustic hyperæsthesia,
with complete or partial deafness, accompanying facial paralysis,
with or without paresis of the limbs of the opposite side, indicate
clearly a tumor of the base so situated as to involve the superficial
origin or intracranial course of the auditory and facial nerves.

The sense of smell is affected, of course, when the olfactory bulbs

are involved in the growth, either directly or by pressure, as in certain
tumors of the antero-frontal region (Cases 4 and 8). Disturbances in
the power of consciously perceiving odors, or abnormal perceptions
of odors or hallucinations of smell, are sometimes present in cerebral
tumors involving certain convolutions. The lower postero-parietal
region or the temporo-sphenoidal region of the base would seem,
from the few reported cases, to be implicated when this sense is
centrally affected. Smell was lost or impaired in two cases of tumors
of the postero-parietal region, in one limited to the supramarginal
convolutions. In a case reported by Allan McLane Hamilton (Case
47), an induration of the lower part of the right temporo-sphenoidal
lobe involving the uncinate gyrus, the patient, preceding light
epileptic attacks, always had an olfactory aura of a peculiar
character—a disagreeable odor, sometimes of smoke and
sometimes of a fetid character. In this case the olfactory nerves were
examined and found to be healthy.

Taste may be involved in several ways. In the first place, subjective

sensations of taste, particularly the so-called metallic taste, may be
present when the growths involve the cranial nerves in such a way
as to cause irritation to be conveyed to the nucleus of the
hypoglossal. When it is remembered that a mild galvanic current
applied to the nape of the neck or face will often cause this metallic
taste, it can be seen that the irritation of a tumor situated at almost
any point of the base might lead to abnormal taste-phenomena.
Neoplasms involving the trunk of the portio dura may of course
cause diminution or loss of taste on the anterior extremity of the
tongue by the involvement of the chorda tympani nerve. In the very
few cases in which the hypoglossal trunk may be involved
disturbances of taste posteriorly may occur. In two cases (Cases 33
and 36) some possible indications as to the cortical areas of taste
are given. One was a tumor so situated as to cause pressure on the
orbital, and possibly anterior, portion of the temporo-sphenoidal lobe;
the other was a lesion closely localized to the supramarginal lobule.

Trophic disturbances of decided character are sometimes present in

cases of brain tumor. Their presence, character, and extent depend
upon the position of the tumor and the cranial nerves involved.
Trophic disorders of the eye have been noted in cases of tumor of
the antero-frontal region, and also of various positions at the base,
especially those so situated as to involve the trigeminal nerve. In a
fibroma of the superior antero-frontal region (Case 1) conjunctivitis
and corneitis of the left eye, with anæsthesia of the conjunctiva, were
present, and were very marked symptoms. This patient, who was
under the care of one of us at the Philadelphia Hospital, was
examined by O. E. Shakespeare, ophthalmologist to the hospital. At
his first examination the bulbar conjunctivæ were slightly injected
and the cornea clear. The sensibility of the cornea was possibly a
little lowered. Ten days later, at a second examination, the central
corneal epithelium of the left eye was found to be hazy and the
whole bulbar conjuntivæ much congested. “This condition soon
developed into a severe superficial corneitis, which was mainly
limited to a central area of an extent about equal to three-fourths of
the diameter of the cornea, which threatened to slough, a narrow
peripheral ring of the cornea being comparative unaffected. At the
same time the engorgement of the bulbar conjunctiva increased. The
sclera, the iris, and the deeper parts were apparently not involved in
the inflammatory process.”

Disturbances of respiration were observed in a number of cases in

various stages. Cheyne-Stokes breathing was usually a late
symptom. In a case of tubercular meningitis with a tubercular
granulation springing from the left side of the fourth ventricle (Case
82) it was present. Extraordinary slowing of respiration occurred in a
tumor of the right middle cerebellar peduncle and cerebellar
hemisphere which caused irritation and softening of the floor of the
fourth ventricle. The respirations ran as low as four and five per
minute two weeks before death.

Persistent epistaxis and a tendency to hemorrhage from the mucous

membranes were interesting vaso-motor phenomena in a case
situated in the upper left quarter of the pons (Case 84). Profuse
perspiration, more marked on one side, was observed in a case of
tumor in front of the optic chiasm. Polyphagia was observed in two
cases, one a growth of the cerebellum and the other on the floor of
the skull. Polyuria was a very marked symptom in Case 95, a tumor
at the base of the brain at a spot corresponding to the sella turcica,
and diabetes was present in a case of frontal tumor. Albuminuria was
recorded twice—once in the same case in which diabetes was
present, and again in a case of multiple tumor of the supramarginal
convolution of one side and the angular gyrus of the other.
Somnolence was occasionally observed.

Constipation or torpor of the bowels occurs somewhat frequently in

the early stages of the brain tumor, giving place in the terminal
periods to involuntary evacuations. The conditions of the bladder are
practically the same. It is either not involved or suffers from torpor or
paresis of the muscular walls early in the disorder, and later, and
especially very late, incontinence from paralysis of the sphincter
results.

DURATION, COURSE, AND TERMINATION.—The duration of cases of

intracranial tumor is very uncertain. In many of the reported cases no
definite information is given as to the exact length of time from the
initial symptoms until the fatal termination. The few cases in which
the time was recorded showed a duration of from three months to as
many years.

In a few cases, even in some which are not syphilitic in character, a

remission of all the symptoms and what appears to be an
approximate cure sometimes take place, the general symptoms,
such as headache, vertigo, vomiting, spasms, etc., disappearing for
a time. Even the condition of the eyes and the paralysis in rare
instances make marked improvement. In these cases, in all
probability, the progress of the growth of the tumor is arrested either
by the remedies employed or spontaneously, and the acute or
subacute phenomena of congestion, œdema, etc. around the tumor
subside. These patients may remain for a long period or until cut off
by some other disease without any change for the worse; but the
sword constantly hangs above their heads, and any excitement,
traumatism, the abuse of alcohol or other narcotics, an attack of
fever, or some other special exciting cause, may again light up the
intracranial disorder, to then progress more or less rapidly to a fatal
termination.

This fatal termination may occur in various ways. Sometimes a

sudden apoplectic attack occurs. This may be an intercurrent
hemorrhagic apoplexy, although our personal experience would not
lead us to believe this mode of termination is common. In a few
cases the enormous irritation of the cerebral growth suddenly or
gradually inhibits the heart's action through the impression made on
the pneumogastric. Apoplectic attacks which may or may not
terminate fatally sometimes are the result of a sudden giving way of
necrosed brain-tissue, the necrosis having resulted from the
obliteration of numerous blood-vessels by the advancing growth.
Blood-poisoning occasionally takes place from abscesses in
proximity to the tumor. In some cases the patients slowly but surely
emaciate, or are exhausted and worn out by the agonizing pain and
incessant vomiting which they are called upon to endure.
Occasionally a more or less diffused and violent meningitis hastens
the fatal issue.
COMPLICATIONS AND SEQUELÆ.—Tumors of the brain may be
complicated with other affections due to the same cause. Thus, for
example, in a case of gumma other evidences of syphilis may be
present in the form of nodes, eruptions, etc. A sarcoma or carcinoma
of the brain may be associated with similar disease in other organs.
Such affections as cystitis, pyelitis, keratitis, etc., which have been
discussed under Symptomatology, are secondary complications of
cases of tumor. As intracranial tumors almost invariably terminate
fatally, strictly speaking we have no sequelæ.

PATHOLOGY.—We present in tabular form the various classes of

tumors found in the one hundred cases of brain tumor in the table
appended to this article:

Carcinoma 7 Glio-sarcoma 1
Cholesteotoma 1 Gumma 13
Cyst 2 Lipoma 1
Echinococcus 2 Myxo-sarcoma 1
Enchondroma 1 Myxo-glioma 2
Endothelioma 1 Osteoma 2
Fibro-glioma 2 Sarcoma 15
Fibroma 4 Tubercle 13
Glioma 16 Unclassified 16

The histology of tumors of the brain does not in the main differ from
that of the same growths as found in other parts of the body, so that
a detailed description of their structures, even though founded upon
original research, could not offer many novel facts in a field which
has been so thoroughly cultivated. Such a description would
probably repeat facts which have already been presented in other
parts of this work, and which are better and more appropriately put
forth in special treatises devoted to the science of pathology. It is
proper, however, for the sake of convenience and thoroughness, to
make brief mention of the structure of brain tumors, and especially to
dwell upon certain features of these morbid growths which may be
considered characteristic of their encephalic location, and hence
have not only pathological but also clinical interest. It is hardly worth
while to refer to speculations which aim to elucidate the very
foundations of the science, except that in a few of these theories we
gain an additional insight into both the structure and conduct of some
very characteristic brain tumors.

Cohnheim's theory was that tumors are formed from foci of

embryonal tissue which had been non-utilized or left over in the intra-
uterine development of the body. Many have not accepted this idea,
but have rather considered that in tumors we witness a reversion of
tissue to lower or embryonic types.28 Whether we accept either or
neither of these propositions, the idea sought to be conveyed is that
in all these morbid structures we have a tissue of low or degraded
character, springing in most instances from a connective or non-
differentiated tissue. This fact is brought out very clearly in many of
these intracranial growths. Virchow29 has said that tumors originate
in the cells of the connective tissue, although his law has been
condemned as not of sufficient breadth, since it seems to ignore the
epithelial and myomatous tumors. Dermoid cysts, of which an
example is given in the table of spinal tumors,30 are said to illustrate
the embryonic function revived—i.e. the tendency of lower tissues to
spontaneously differentiate into higher and more complex ones.
28 Article “Pathology” in Brit. Encyc., by C. Creighton.

29 Quoted by Cornil and Ranvier.

30 Page 1107.

The gliomata are among the most common and characteristic tumors
of the cerebro-spinal axis, to which system and its prolongation into
the retina they are confined. They invariably spring from the
neuroglia or connective tissue of the nerve-centres, and reproduce
this tissue in an embryonal state. They greatly resemble the brain-
substance to naked-eye inspection, but have, histologically, several
varieties of structure. These variations depend upon the relations of
the cell-elements to the fibres or felted matrix of the neoplasm. In the
hard variety the well-packed fibrous tissue preponderates over the
cell-elements, and we have a tumor resembling not a little the
fibromata (Obernier). The second variety, or soft gliomata, show a
marked increase of cells of varied shapes and sizes, with a rich
vascular supply which allies these growths to the sarcomata. The
elements of gliomata sometimes assume a mucoid character, which
allies them, again, to the myxomata.
 FIG. 43.

Flat Glioma-cell with its Fibrillar Connections (Osler).

FIG. 44.
 (1) Homogeneous translucent fibre-cell; (2) cells like unipolar ganglion-
cells; (3) giant cell (Osler).

W. Osler has recently described31 to the Philadelphia Neurological

Society the structure of certain of these tumors, from which we
abstract the following facts: One point referred to is that gliomata
sometimes contain larger cells and coarser fibres than are usually
shown. The structures are (1) The “spinnen” or spider-cells
(characteristic of glioma), which present variations in size; (2) large
spindle-shaped cells with single large nuclei (some of the largest
cells met with in tumors); (3) cells like the ganglion-cells of nerve-
centres, with large nuclei and one or more processes: some are
balloon-shaped with single processes; they are larger than the
spider-cells; (4) translucent band-like fibres, tapering at each end,
without nucleus or granular protoplasm, regarded as a vitreous or
hyaline transformation of the large spindle-cells. Klebs (quoted by
Osler) holds that the ganglion-like cells are derived from the nerve-
cells of the gray matter, “and that in the development of this variety
all elements of the nerve-tissue participate.” Osler examined the
advancing region of the tumor, and was not able to satisfy himself
that the nerve-cells were in process of proliferation. He thinks they
are connective-tissue elements. He has seen but two out of five
cerebral gliomata which were of small-celled type.
31 “Structure of Certain Gliomas,” Philada. Med. News, Feb. 20, 1886.

The gliomata are subject to fatty degeneration, which usually occurs

in the central (older) portions of the mass. The more vascular forms
are also peculiarly liable to hemorrhage, which is probably caused in
some instances by this process of retrograde metamorphosis. These
hemorrhages resemble apoplexies, not only in their clinical features,
but also on gross examination. Great care is therefore often
necessary at the autopsy to distinguish such a hemorrhage,
occurring as it does in a brain-like neoplasm, from one caused by the
rupture of a diseased artery. The hypertrophy of the pineal gland,
sometimes noted, is caused by the formation of gliomatous tissue.
Under the microscope it is necessary carefully to distinguish some
forms of inflammatory new formations from the gliomata. We have
recently seen, by the courtesy of E. N. Brush of the Pennsylvania
Hospital for the Insane, photographs of microscopic sections from
the ependyma of the lateral ventricles in a case of general paresis,
which showed the structure of this degenerated tissue to be a
compound of fibres and cells of marked resemblance to gliomatous
tissue.32
32 These micro-photographs were prepared in the laboratory of the State Lunatic
Asylum, Utica, New York, by Theodore Deecke.
Sarcomata of the brain are common, as our table shows. In them the
cell-elements predominate, both in the large- and small-celled
variety. They are malignant and grow rapidly. The form known as
alveolar sarcoma, which has a distinct stroma, is to be distinguished
from the cancers; which has probably not always been done.

Tubercle, according to Ross, is the most common of all forms of

brain tumor. Our table shows 13 cases out of 100, the gliomata and
sarcomata being in larger number. Its favorite seat is in the cortex of
both the cerebrum and cerebellum: some observations appear to
show that it is more common in the cerebellum and mid-brain region
than in the fore-brain, and in children than in adults; some of which
points distinguish it from the gummata, which are more common in
adults and occur anywhere. Tubercle is another form of development
from the connective tissues, usually dependent upon a constitutional
taint or predisposition: in it the cell-elements have generally
undergone a degeneration into an amorphous cheesy mass. It is apt
to be multiple and accompanied by a similar deposit in other organs
of the body.

True neuromata are probably very rare growths, and it is likely that
some tumors which have been described as such are really
connective-tissue tumors of a gliomatous nature, in which some of
the cell-elements have been mistaken for the ganglion-cells.
Obernier33 says that these tumors are small and grow from the gray
matter on the surface, also on the ventricular surfaces. They are also
found in the white matter. He says they are only found in persons
having some congenital or acquired aberration; by which is probably
meant some other well-marked neurosis or psychosis. The one
hundred tabulated cases afforded no examples of neuromata.
33 Op. cit.

Myxomata are not, histologically, to be distinguished from the

gliomatous tissues by anything but the peculiar mucoid changes
which their structures have undergone. They are more rare in the
brain, as our tables show, than in the spinal cord.
Lipomata are very rare in the brain, according to most observers.
The table shows but one example. These tumors, as their name
signifies, are made of fat-bearing tissues—another of the connective-
tissue class.

The angiomata, somewhat rarely found within the skull, are noted for
their abnormal development of the vascular tissues: they are
composed mainly of blood-vessels and the connective tissue, which
supports them in closely-packed masses. They also present
cavernous enlargements. They are of especial interest in cerebral
pathology, because the lesion known as pachymeningitis
hæmorrhagica, often found in dementia paralytica, is considered by
some to be angiomatous; although by far the most generally
accepted view of this latter condition is that it is due to arterial
degeneration, and in part is an inflammatory exudate.

Syphilitic tumors, or gummata, are, like tubercle, a special

development with degeneration from the connective tissue, due to a
constitutional taint. This new growth is sometimes single, sometimes
multiple. The corpuscles of the neuroglia are the apparent points of
origin of the tumor, the substance of which is the firm, peculiarly
gummy, and non-juicy material from which the name is derived. It
would be impossible in our allowed space to trace this neoplasm
through the successive stages of its development. It has especial
clinical interest, inasmuch as it and its damage are probably
amenable to specific treatment when it has not progressed to too
great a destruction of brain-tissue.

The true cancers, or epithelial neoplasms, are not a common form of

tumor of either the brain or spinal cord. They present, as in other
parts of the body, a stroma forming alveolar spaces in which are
contained the nests of epithelial cells. These tumors thus present
characteristic differences in their histology from the connective-tissue
or mesoblastic groups, but clinically no very special interest attaches
to them. Their location, the rapidity of their growth, and their fatal
import are points which they share with most other new growths of
the cranial cavity.
The cholesteotomata, or pearl cancers, consist of hardened
epithelial cells which have undergone a sort of fatty degeneration.

The psammomata are loosely described as tumors containing sand-

like bodies, which bodies are normal about the pineal gland. These
sand-like bodies are found in tumors of some histological diversity,
and do not appear to have much identity of their own. They occur in
sarcomata and carcinomata, and are probably not to be
distinguished from mere calcareous infiltration and degeneration.
They are most common in sarcomata, as this is one of the most
common of cerebral tumors.

True osteomata—i.e. tumors with the structure of true bone—are

probably rare in the brain, although more common on the inner table
of the cranium; but the deposition of calcareous salts has been
recorded in a variety of conditions. F. X. Dercum, in a recent paper
read before the Philadelphia Pathological Society,34 has recorded the
autopsy of a paretic dement in which case calcareous deposits were
scattered throughout both hemispheres and the cerebellum. He
believes that “the areas in which the concretions were found were
probably foci of encephalitis of greater intensity than elsewhere. In
these foci inflammatory changes in the walls of the vessels became
pronounced; besides which the vessels increased enormously in
size and number; so marked is this increase that these foci could,
with perfect propriety, be called angiomata.” This is followed by
proliferation of the neuroglia, compression and destruction of nerve-
tissue, and deposit of the calcareous salts especially about and upon
the coats of the vessels. This case illustrates in the simplest manner
the formation of both vascular and sand tumors.
34 The Medical News, April 24, 1886, p. 460.

Pacchionian bodies are very common in the brain, and are really
small fibromata. They may form true tumors (Cornil and Ranvier)
capable of wearing away the bones of the cranium. In fact, even
when small they may have corresponding indentations in the skull.
They are not to be mistaken for tubercle. Clouston35 has described
excrescences from the white matter of the brain, growing through the
convolutions, projecting through the dura mater, and indenting the
inner table of the skull; which new growths he calls hernia of the
brain through the dura. We have not seen such a condition
described elsewhere, and think that we have here probably
Pacchionian bodies growing from the pia mater. They were found in
a case of tumor of the cerebellum.
35 Journ. Ment. Sci., xviii. p. 153.

A cystic formation, constituting a veritable tumor, not unfrequently

occurs in the pituitary body and mounts into the third and lateral
ventricles. Echinococci and hydatids also occur, and have the same
natural history as these parasitic offspring have when found in other
parts of the human body.

Obernier refers to an enchondrosis of the basilar process. Our table

presents one case of enchondroma.

Some of the gross appearances found on autopsies of tumors of the

brain are worthy of note. Often an area of congestion or
inflammation, especially of the membranes, is seen about the new
growth, and the brain-substance in its immediate vicinity is much
more frequently softened. The cerebro-spinal fluid is increased, and,
especially when direct pressure has been exerted upon the veins of
Galen, are found distended lateral ventricles. When a tumor does not
approach the surface, but has attained some size, the hemisphere in
which it is located often has a bulging appearance, crowding over
upon its neighbor, and the convolutions are flattened by the
pressure. The cranial nerve-trunks are occasionally involved in or
stretched by the tumor, and also occasionally the bones of the vault
or base of the cranium are extensively eroded. This happens
especially in cancer and osteo-sarcoma.

A few remarks should be made about the methods of making post-

mortem examinations and the gross appearances and conditions
likely to be found in brain-tumor cases. As not a few intracranial
tumors are connected with the bone or with the dura mater, the latter
being adherent to the skull-cap in some positions because of
inflammation arising from the seat of the growth, especial care
should be taken in removing the calvarium. Examination of the
external surface of the dura mater will sometimes reveal the
presence of a growth beneath or incorporated with this membrane.
The dura mater should not be roughly dragged from the surface of
the brain, but should be carefully removed by a process of partial
dissection. During this process a meningeal growth will sometimes
be found growing apparently from the fused membrane. In such
cases it is usually better to so proceed as not to entirely separate the
outer membrane from the growth. Indeed, this cannot be done
sometimes without injury directly to the specimen, and especially to
its cerebral surroundings. The dura mater having been removed, a
marked opacity, sometimes a dirty-brown hue shading off into a
lighter color, will indicate to the eye the probable presence of a tumor
beneath and growing from the pia mater of the cortex. In such a
case, and even when no such appearance is present, but a tumor is
suspected, the fingers passed carefully over the cerebral surface will
feel a hard, and it may be nodulated, mass at some position. A
growth, having been located in this way, should not be roughly
handled or at once examined by section. An effort should be made to
accurately localize it, not only with reference to lobes, but also with
reference to convolutions and fissures, and even special portions of
these. This is best done, after a thorough examination has been
made of the pia mater, by carefully stripping the pia mater from the
brain, beginning at points some distance from the growth and
gradually approaching it, and leaving the pia mater for a short
distance around the growth connected with it. The location having
been fixed and other portions of the brain having been examined, if it
is not possible or desirable to retain the entire brain as a specimen, a
block should be removed embracing a considerable portion of
healthy brain-tissue on all sides of the tumor. In order to study the
gross internal appearance of the tumor, it is a good plan to make a
clean section through the middle of the tumor. From each side of this
cut fragments can be taken for microscopical examination without
deranging appreciably the size and appearance of the tumor.
When the tumor is not meningeal or cortical, or not situated at the
base or floor of the skull, its presence may be revealed, when it is in
centrum ovale and of considerable size, by either hardness or
fluctuation of the hemisphere in which it is located, this fluctuation
not being due to the tumor itself so much as to the breakdown of
tissue around it. Large sections in known positions with reference to
convolutions and ganglia should be made when examined for tumors
deeply situated. If possible, sections close to and just before and
behind the growth should be made, so as to assist in the accurate
localization.

Small tumors are not infrequently overlooked by careless observers,

and even growths of considerable size have escaped discovery by
one examiner to be found by another. Tumors in certain special
localities, as between the temporo-occipital lobe and the superior
surface of the cerebellum in the great longitudinal fissure, or small
growths in the substance of the cerebellum or deep in the Sylvian
fissure, are more likely than others to be passed by, although this, of
course, is not likely to occur when the examination is made by a
competent or careful physician.

DIAGNOSIS.—The diagnosis of the existence of an intracranial tumor,

as a rule, is not difficult. It can be made with greater certainty than
that of almost any other serious encephalic disease.

It is sometimes important to decide as to the nature of an intracranial

neoplasm, particularly whether or not it is syphilitic. Little is to be
gained by following the plan adopted by some physicians, of treating
all cases as if they were due to syphilis, on the principle that these
are the only forms of tumor which can be reached by treatment. The
pitiable condition of such patients is sometimes thus made worse. In
every case careful and persistent efforts should be made to obtain
an authentic previous history from the patient. Whenever possible
the physician should search directly for the physical evidences of the
former existence of syphilis—for cicatrices on the genitals and
elsewhere, for nodes and depressions, for post-cervical and other
swellings, etc. A history of previous disease of the throat and of
pains in bones and nerves, of epileptiform attacks, of headache, and
eye symptoms which have disappeared under treatment, should be
sought out. It is not well to give too much credence to the stories of
patients, who are not always willing to admit their past lapses from
virtue; but, on the other hand, the plan of suspecting everybody who
presents advanced cerebral symptoms is often a grievous wrong.
Not infrequently external cranial nodes are present in cases of
intracranial syphilis.

Carcinomata and sarcomata, particularly the former, are

comparatively rapid in their progress. They sometimes involve the
bones of the skull, even to the extent of perforation.

The existence of an inherited tendency and of tuberculosis in other

organs, with the special phenomena of general tuberculosis, assists
in the diagnosis of tubercular tumors.

The frequent occurrence of gliomata in early life, and the

comparatively frequent absence of severe irritative symptoms, with
the well-preserved general nutrition of the patient, speak for these
growths.

Cerebral abscess is, on the whole, more difficult to diagnosticate

from intracranial tumor than any other affection. Abscess, however,
more frequently than tumor, can be traced directly to a traumatism. It
is often associated with disease of the internal ear. Obernier speaks
of the headache of cerebral abscess as slight, but this does not
correspond with usual experience. Headache, on the whole, may be
oftener absent or less agonizing in abscess than in tumor, but it is
frequently present, and sometimes of great severity. Its greater
mildness in a few cases is to be explained by the fact that abscess
does not produce so much pressure within the intracranial cavity,
and does not so frequently cause irritation of the branches of the
trigeminus in the dura. Undoubtedly, the symptoms of abscess often
remain for a long time comparatively latent, with then a sudden
outburst of violent symptoms. The course of brain tumor is more
uniformly and steadily progressive, and febrile phenomena, the
results of pyæmia, are of more frequent occurrence in abscess than
in tumor.

In old cases of tumor it is sometimes necessary to differentiate

between it and the results of various forms of apoplexy, such as
hemorrhage, thrombosis, and embolism. Cerebral hemorrhage,
embolism, or thrombosis leaves a condition of paralysis, sometimes
with, but usually without, accompanying spasm or convulsion, which
simulates closely the paralysis and other permanent conditions of
cases of tumor occurring in the same cerebral locality. In these
cases, in the first place, the history of the disease will throw
considerable light upon the diagnosis. In both hemorrhage and
embolism the history is usually one of a sudden attack without
special premonitory symptoms. Hemorrhage gives usually a
precedent history of diseased kidneys, hypertrophied heart, or
atheromatous blood-vessels, and occurs generally in advanced life;
embolism, a history of rheumatism and valvular disease of the heart,
occurring at any period of life, early or late. In brain tumor the
previous history is usually one of traumatism, of constitutional
infection, or of a special predisposing diathesis. Blows and falls upon
the head are common antecedents, or a history of syphilis,
tuberculosis, scrofula, or cancer is present. Tumor, like embolism
and unlike hemorrhage, may occur at any time of life. While slight or
dull headache, with more or less vertigo, may be present in cases of
hemorrhage and thrombosis, the severe and often agonizing
headache, with vomiting and serious vertiginous attacks, which
precedes the paralytic or other phenomena of tumor, is a much more
conclusive symptom in the latter cases than in the former. Choked
discs and optic neuritis are much more likely to occur in tumor than
in the other affections.

Brain tumor must sometimes be diagnosticated from the head

symptoms of some form of Bright's disease. A case not long since
presented itself to one of us with a history of having suffered at
frequent intervals for two years with headache of gradually
increasing severity. Dimness of vision and slight temporary œdema
of the feet, circumscribed and painful swellings along the lymphatics
of the thighs and legs, with some mental irritability, were other
marked symptoms. The patient had been attended by several
physicians of prominence, one of whom had diagnosticated tumor of
the brain. The violent, apparently agonizing headache, with the
diminution of vision, and the absence of marked symptoms indicating
other organic disease, made the diagnosis of a growth in some non-
excitable region of the cerebrum most probable. Examination of the
urine showed no albumen. Careful examination of the eye-ground
with the ophthalmoscope, however, revealed the appearances of
retinitis albuminurica. Under a treatment directed to the relief of
chronic nephritis the patient's headache and other symptoms
improved.

It must not be forgotten just here, however, that, on the one hand,
ophthalmoscopic appearances very similar to those of albuminuric
retinitis are sometimes present in rare cases of brain tumor, and also
in other constitutional disorders, such as leukæmia; and, on the
other hand, that, as stated by Norris,36 exceptional forms of
albuminuric retinitis have been reported where the only change seen
in the fundus oculi was pronounced choking of the disc.
36 Op. cit.

Intracranial tumors must be diagnosticated from meningitis in its

various forms. In children tubercular meningitis sometimes closely
simulates brain tumor. Tumors of the brain are comparatively rare in
children, but, as has already been shown, gliomata and other tumors
do sometimes occur in early life. The course of tubercular meningitis,
whether in children or in adults, differs from that of brain tumor. It is
more irregular in its method of advance, or if it shows the regularity
which is sometimes present, and which has led authors to subdivide
it into three more or less completely separable stages, the symptoms
of these stages do not correspond with any closeness to those of the
initial, middle, and terminal periods of brain tumor, as already given.
Headache is usually present in both affections, although the absence
of headache in some cases of gliomata in children must be here
borne in mind. When headache is present in tubercular meningitis, it