Surgical essays: the result of clinical observations made at Guy's Hospital / [Bransby Blake Cooper].
- Bransby Blake Cooper
- Date:
- 1833
Licence: Public Domain Mark
Credit: Surgical essays: the result of clinical observations made at Guy's Hospital / [Bransby Blake Cooper]. Source: Wellcome Collection.
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![In my opinion, no case can better illustrate the propriety of leaving to nature the reparation of injured bone, where the brain has not suffered from the accident, and trusting wholly to constitutional means of preventing subsequent inflammation of the brain, and its membranes. It would have been impossible, by any mechanical means, to have elevated the depressed bone, without having inflicted an injury to the brain, which, from the absence of all symptoms, it clearly had not yet sustained. From this case, then, as well as from experience generally, I should say, never remove a portion of the bones of the skull, unless there be direct evidence of its affecting either the brain or its membranes, CASE. Richard Slatter, aged 30, was brought into the accident ward of Guy’s Hospital, on the 11th of June, labouring under symptoms of concussion of the brain, occasioned by the wheel of a gig passing over his head. Upon his first admission, his pulse were full, but compressible, and about fifty; his pupils were dilated, the right rather more than the left; his skin rather cooler, than natural ; he complained of great pain on the forehead, and over the left ear, but it was difficult to obtain any answer from him when spoken to. A short time after he had been put ‘to bed, he had considerable hemorrhage from the left ear, and from the nose, no bleeding having occurred before this period. He complained of nausea and giddiness, and was constantly rolling from side to side in his bed, and moaning as if in great pain. The pulse now became hard and labouring, the skin hot, and all the symptoms of reaction coming on, he was bled to sixteen ounces, eight grains of calomel] were given to him, and a common enema was administered. On the 12th, he had passed a good night, and was free from restless- ness, his skin was cool, bowels had been well opened, the pupils remained however dilated, but he was quite sensible. His tongue was covered with a brown fur, and he complained of great pain over the forehead and left ear. Applicentur Temporibus CC. c ferro ad 3x. Repet. enema. 13th.—At about 10 o’clock, a, mM. all the symptoms of compression came on: stertorous breathing ; entire loss of volition and sensation ; twitchings of the left side of the face; extremities became quite cold. At 2, Pp. m., no pulse could be felt at the wrist, and at half-past three he died.](https://iiif.wellcomecollection.org/image/b22009255_0039.jp2/full/800%2C/0/default.jpg)
