On middle meningeal haemorrhage / by W.H.A. Jacobson.

  • Jacobson, Walter Hamilton Acland, (1847-1924)
Date:
[1885?]
Catalogue details

Licence: Public Domain Mark

Credit: On middle meningeal haemorrhage / by W.H.A. Jacobson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    injury ; complete recovery.—J. H—, set. 27, a spare, dellcate- lookiug man, the Boots in the Golden Fleece, was seized on the 18th of April, at the commencement of a voyage to the Crimea, with a fit of epilepsy, for which I was called to see him. I found him lying on the deck with all the usual sym- ptoms of that affection. In a few minutes he recovered his consciousness and was able to answer my questions, and walked to his berth apparently well. On my seeing him half an hour afterwards, to my surprise I found him drowsy, stupid, and nearly insensible; in an hour^s time he became completely so. His pulse became full, slow, and labouring; the pupils fijted and dilated; the skin hot, and the motions passed in- voluntarily. I ordered his head to be shaved, and carefully examined it to see if there was any external fracture. None, however, was perceptible, a slight bruise only being visible on the right side. I therefore ordered a large blister to be placed on his scalp, fifteen grains of calomel to be given through the medium of butter, and a strong turpentine enema to be injected. In the evening the right side of his body Avas completely paralysed, and there was no improvement whatever. For three days this state of things continued, the same treatment being resorted to. I was now convinced that unless something further was quickly done he would sink, and that, from the symptoms of the case, it was compression from extravasation. Bearing in mind Mr. Hilton's opinions on these cases, on the 22nd I trephined over the site of the middle meningeal artery on the left side. On removing the bone, to my great pleasure I found a large clot of blood between the bone and dura mater. This I removed, and in two hours afterwards the man had recovered his consciousness, and could speak distinctly and rationally; the paralysis also entirely disappeared. He went on well for the next four days, and on our arrival at Malta I sent him to the hospital there, as it would be some time before he was able to attend to his duties. At the expiration of a month the wound had nearly healed, and he had nothing whatever to complain of. I therefore ordered him on board to resume his duties. In a couple of weeks the wound had entirely healed, and he went on per- forming his duties till our arrival in England in July, when he was discharged perfectly well.
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