Injuries and surgical diseases of the head / William Mac Cormac.

  • Maccormac, William, Sir, 1836-1901.
Date:
[1901?]
Catalogue details

Licence: In copyright

Credit: Injuries and surgical diseases of the head / William Mac Cormac. 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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    The old rule, however, never to convert a simple into a compound fracture for purposes of exploration or opera- tion, has been greatly modified by the introduction of antiseptic methods of treatment. 2. By the presence of a foreign body in the interior of the skull which cannot be otherwise extracted. A bullet in the brain may thus be searched for, and broken-off knife points, or portions of weapons, detected and extracted. 3. In progressive bleeding from a torn middle meningeal artery. 4. In secondary diffuse suppuration, and in brain abscess. In the former class of cases trephining has sometimes been employed to facilitate the escape of matter, and the ap- plication of an antiseptic treatment. The suppuration, however, in these cases is diffused, and but little gain can be effected. In the latter form, where the collection of pus is localized, about half of the cases operated on have been cured in what must otherwise prove a fatal malady. 5. In cases where possibly long after the receipt of the injury serious symptoms of interference with the brain functions set in, or epileptiform seizures occur, and it seems probable that these may depend on thickening of the bone, a bone spicule, or a depressed and com- minuted internal table pressing upon and irritating the brain. 6. Trephining has also been performed as a means of removing a tumour of the brain from within the skull. Prophylactic trephining has become a possible and recognized manner of dealing with cases of fracture, simple as well as compound, where, though there may be no immediate symptoms or only very slight ones, the nature of the injury leads us to expect them at a later date. Trephining is contra-indicated— 1. In all cases where there is insufficient evidence of the locality of the disease or injury to the brain.