A handy-book of forensic medicine and toxicology / by W. Bathurst Woodman and Charles Meymott Tidy.

Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: A handy-book of forensic medicine and toxicology / by W. Bathurst Woodman and Charles Meymott Tidy. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    tho patient lying as if asleep ; but when excited, the carotids pulsate rapidly, the pulse beating 140 or 150 ; and if roused, he may answer questions. Some of these patients may resemble somnambulists: they will get out of bed to make water, or go to the closet, or they will bolt the door, shave themselves, take food in a mechanical way (when fed, or when the food is close to them), yet still appear insensible to all around them. One of the Authors knew such a condition to last twenty-one days in a quarryman, who ultimately recovered perfectly, with no paralysis or impairment of brain functions. Or recovery may be imperfect, loss of memory, an imbecile constitution, or state of demen- tia, or enfeebled intellect, loss of sexual and bodily power, and impaired sight, hearing, and other nervous functions, may be the results. The consequences of concussion of the brain greatly depend on the mode in which the injury is inflicted. A sudden violent shock may stop the heart at once, and prove fatal; or inflict injuries on the brain, which may be irremediable; '* whilst a more gradual and less violent injury may be far better tolerated. Mayo showed that if you suddenly crush a very small part of an animal’s brain, the heart stops at once, whilst nearly the whole brain may be gently sliced away, with little or no effect, except loss of special functions. Mr. Guthrie (in “ Injuries of the Head,” &c., London, 1842, p. 11) strongly deprecated any very active measures in the treatment of concussion. The patient should be left quiet to recover, in most cases, though friction and warmth to the feet sometimes seem useful. [One of the Authors has used artificial respiration in a few cases.] Advantage, as Miller well says, should be taken of this condition to examine for other injuries, such as broken bones, dislocations, and wounds. Concussion, especially when the brain or its membranes are much lacerated, may be followed by meningitis and encephalitis. For the symptoms of these, and the after-treatment of concussion, we must refer to the articles on this subject in Erichsen’s, Miller’s, Druitt’s, Pirrie’s, and Bryant’s “ Manuals of Surgery,” to the articles on “Con- cussion and Injuries of the Head,” in Cooper’s “ Dictionary of Surgery,” and Holmes’ “ System of Surgery,” and to the monographs of Prescott, Ilewett, Guthrie, Sharp, Hilton, and others. See also the opinion of Chassaignac, Langier, and Robert, quoted in Ranking’s “ Abstract,” vols. ii. and iii. Concussion may prove fatal at the moment. Thus a man may fall on the pavement from tripping his foot, and be picked up dead. See also South’s Chelius’ “ Surgery,” vol. i., p. 408. This may depend entirely on nervous shock. Sudden death occurred in the case of Regina v. Burgess (Liverpool Lent Assizes, 1845). Consciousness is sometimes * Dr. Druitt adds a foot-note to this effect :—“ The blunt, heavy dragoon sword of the English will not penetrate the head-dress of the Sikh or Afghan ; yet the enemy is mostly beaten from his horse, and frequently killed by the violence of the shock. The trenchant blade of the Sikh, wielded by a strong man, will cut through any head-piece, and perhaps bury itself in the brain ; and yet yon find no symp- toms of concussion or compression. In the former example, the soldier is effectually disabled, often killed outright; in the latter, though mortally wounded, he may be able to continue the fight, and even to kill liis antagonist, before he himself falls dead or dying from his horse.” (Cole’s “ Field Practice in India,” p. 45. Sec also a very able paper by Dr. It. C. Williams iu the “British and Foreign Quarterly ” January, 1853.)