Contribution to the morbid anatomy and pathogenesis of chronic internal hydrocephalus / by Harold J. Stiles.

  • Harold Stiles
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Contribution to the morbid anatomy and pathogenesis of chronic internal hydrocephalus / by Harold J. Stiles. 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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    and the remaining three are alive and well. Although no definite history of syphilis could be obtained, it was a little doubtful if such a taint could be altogether excluded. Progress and Treatment. — The child was under treat- ment from the time it was 8 weeks old until its death at the age of 5 months. The main facts in the progress of the case may be gathered from the following table;— Date. Circumference of bead (in inches.) From ear to ear over vertex (in inches). Fluid removed (in ounces). Sep. 27, . 17i 10} Oct. 7, 19 in 1 „ 11, . 19} 111 „ 18, . . 19l 11} 2 „ 21, . 19| m „ 25, . . 20} Hi „ 28, . . 20} 12} Nov. 4, 21 12} 2} „ 11, . 21} 13 „ 18, . 2li 13 „ 25, . . 20| 12} 3 „ 29, . 2l| 13 Dec. 5, 2l| 13} „ 19, . 22 13} 3 Jan. 2, 22} 14 4} „ 19, . 23 14} 5} Feb. 4 (died), . 23i 15 7 Having regard to the fact that the child was an out- patient, and to the unsatisfactory results which have been obtained by continuous drainage, it was decided to try the effect of repeated tappings, care being taken to use eveiy precaution to avoid the introduction of micro-organisms. After shaving and thoroughly purifying the skin, a small metal trocar and cannula (previously sterilised by boil- ing) was introduced into the ventricle through the large membranous area of the anterior fontanelle, about in. from the middle line, on the right and left sides alternately. After withdrawing the fluid, the puncture was securely closed by a large and thick collodion dressing, over which corrosive wool and a domette bandage was applied to keep up a certain amount of pressure. No antesthetic was used.
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