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.

    154/174 (page 142)
    subjects of those observations I have alluded to, page 19, the favourable issue resulting from graduated pressure on the hrain. The pressure was graduated according to the feeling of the individuals ; when made too firmly it gave rise to swimmings and pain in the head, retardation of the pulse, a sense of sickness and fainting, and even in one instance to syncope. Pressure could only be borne when very lightly applied whilst the protrusion was increasing, but could be gradually augmented when it became stationary, and during its diminution and secession. The pressure was continued until after the wound had healed. 1 had occasion at Santander to remove a portion of bone, including the upper part of the lambdoidal suture of the right side, from the head of a soldier of the ^ Light division, wounded by a musket-ball on the heights of Vera, which had frac- tured and depressed the skull at that part some weeks before, in consequence of symptoms of irritation having come on after an irregularity in drinking. A piece of bone was depressed, and had irritated the dura mater at the part; the membrane had some matter upon its surface, and was evidently abraded. The operation gave relief, but a tumour soon sprang up evidently composed of brain. The patient was again bled, purged and starved; calomel and opium were given in moderate doses, and the protrusion ceased to increase; about the same time it changed colour, became yellow, fetid, softer, and slowly wasted away, pieces of dead matter separating at each dressing, until it sunk within the level of the protrusion increases ; he complains of no particular pain ; the discharge is profuse, and of a thin black watery quality. Pulse at 90 ; bowels freely open. V. S. ad 3xvi. Continue the purgatives. 15th. The pulse and bowels natural, the protrusion has scarcely increased; discharge profuse, and still gleety; a small compress was laid over the dressings, and a bandage was lightly applied. 16th. Pulse and secretions natural; the wound looks more healthy ; the discharge something better in appearance ; the fungus does not increase. 19th. Is doing well, and complains of no manner of pain ; functions natural. The protrusion somewhat less; discharge good. A small quantity of cloth has come away. 21st. Discharge improved. Continue the purgatives. 26th. The protrusion evidently diminishes, and begins to heal at the edges. 30tb. The hernia cerebri has considerably diminished ; secretions natu- ral ; a small quantity of bone has come away ; discharge diminished. May 4th. The wound is healing rapidly; the patient is now permitted to get out of bed, and has half diet. Another very small piece of bone has come away. 10th. The wound is now nearly healed. Between the 15th and the 25th several small pieces of bone came away. On the 26th, on intro- ducing the probe, a small piece of bone followed it; and on further examination a large piece was felt quite loose, which was removed by incision. Discharged cured to Bordeaux.