On injuries of the head affecting the brain / By G. J. Guthrie.

  • George James Guthrie
Date:
1842
Catalogue details

Licence: Public Domain Mark

Credit: On injuries of the head affecting the brain / By G. J. Guthrie. Source: Wellcome Collection.

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    SO exactly the size of the ball, and the bone was so clearly to be felt deep in the posterior lobe of the brain, whilst the ball had probably gone beyond it, that I thought it right to recommend the man to have the bone removed. He declined, but begged to have more to eat, which I in turn refused. He had no bad symptoms, and the wound closed in, and had healed when I left him at Bordeaux about to embark for England. It was the recollection of these cases which induced me, after the battle of Waterloo, to recommend, in that of a soldier similarly wounded, that nothing should be done unless symptoms arose demanding the use of the trephine; as none appeared, and the wound healed, the man was sent home to Colchester, where he one day got drunk, and also fell down dead in the market-place. The ball was lodged deeply in the posterior lobe of the brain in a sort of cyst. I have never seen a person live with a fo- reign body lodged in the anterior lobe of the brain, although I have seen several recover with the loss of a portion of the brain at this part. My experience then leads me to believe, that an injury of apparently equal extent is more dan- gerous on the forehead than on the side or middle of the head, and much less so on the back part than on the side. A fracture of the vertex, is of infinitely less importance than one of the base of the cranium, which although not necessarily fatal, is always attended with the utmost danger. The treatment of these several injuries, although they may be at first sight apparently similar, cannot, and must not be alike in all; and this fact should always be borne in mind in their manage- ment. In civil life, both in hospitals and among private persons, injuries of the base of the cranium prevail, from the circumstance of their generally being the consequence of falls ; whilst in military life injuries of the base of the skull are rare, and those of other parts are common. The practice of the military surgeon is therefore more successful, all things considered, than that of the surgeon in civil life, and particularly in a great metropolis; which may perhaps account for some of the discrepancies in opinion which have existed between them. I have often thought with many other persons that I could distinguish the part of the brain injured from the symptoms which took place ; and I sometimes think so still, although no great reliance can be placed on a diagnosis which has been too frequently placed in doubt, or even in error, by examination after death. There are some symptoms which do not admit of dispute as to their cause, but there are infinitely more which are not understood, or which are so mingled B 2