If the dead fed without violence, I believe it should always be done as soon as it is found to be loose. On the treatment of hernia cerebri I have no rein; to of: rdly less important than the immediate treatmentof hoi wounds of the head, is tlieir after-management ('lass of cases requires mop1, n-thrnrd UK TIM: CRIMEAN supervision. Relapses may occur long after the patient is apparently beyond danger; and from the most insignificant causes of which, perhaps, irregularities in food, the use of alcoholic stimuli, and retained evacuations, occupy the foreground a chronic inflammatory condition of the membranes is apt to become established, which is no less difficult to manage, than dangerous in its ultimate results.
Very many cases are on record in which men with balls embedded in the brain have apparently recovered completely, but have suddenly fallen down dead when they had got drunk, or excited. The following cases are added, as in some measure illustrating injuries of various parts of the head. They are selected from a large number whose features are nearly parallel. Hughes, an artilleryman, was admitted into the general hospital under my colleague Mr. Rooke, on the 15th of November. He had been struck over the upper part of the occipital bone by a piece of shell, when the siegetrain on the right attack exploded. He was rendered insensible by the blow. The scalp was considerably lacerated over the right upper part of the occiput, where a stellate fracture was found; part of the bone beniu; depressed for about a quarter of an inch below the surface.
He recovered some degree of consciousness a short time after receiving the blow, but was dull and stupid when admitted into hospital; answering quest ions if urgently put to him. His head was shaved, and cold applied. The next day he was rational; his eyes were bloodshot, but beyond this there was no bad symptom. Purging, and cold locally applied, were used. A few days afterwards he had headache, and intolerance of IN.H OF THE HEAD.. Dimness of vision, and Hushing of the face fol1, but there was no notable peculiarity in the j upil. 1. A i IT nov. I to the mastoid processes; beyond tii of laxatives and ling else was required to dissipate all threatening symptoms, and lie lel't for in January, quite In the above case we had merely concussion at i; followed by a threatening of traumatic encephalitis. t was simple, and the cure complete..
38th regiment, aged twenty-two, v wounded on the morning of the 18th of June, but was not brought into hospital till the evening of the IDth, as Inlay where he could not be got at till the armistice. A of shell had struck him on the upper part of the ig the scalp open to an t xtenl "f two in and a half. The bone, though denuded, was not E to 1",-d. His symptoms were dil in the forehead, and great throbbing in the tenij!! was quite rational, but dull, and had double vision and strabismus. His pupils were slightly; c.iinplaint then, and for some days after, was of which had receded no injury; but; lid glands I -lien ounded side a symptom which I have observe I! similar ea.pulse was forty per minute when he sat up. ve purgiii,,f the p 'he use of low diet, his bad symptoms p-adually appeared.
For some days after admission his puls.not change, F Till-: CRIMEAN WAK. tinhealthy standard. On three different occasion.-, while he was under my charge, his bowels being unrelieved for a day, his bad symptoms returned in a modified degree, and his pulse sank; while, whenever his lx>wels were freely opened, all uneasiness vanished, and his pulse again rose. The alternation was most curious, and very rapidly developed. This case, like many others, illustrated well the marked sympathy which ei between the head and the bowels. The same slow of the pulse was noticed by Dr. John Thomson, in the case of a similar injury after Waterloo.
A French soldier received a ball about an inch behind the left ear, which escaped above the eye of the same side. His antagonist, who shot him, was close to him at the moment he tired. This man fell down insensible, and was carried to the ambulance; but he recovered his senses before his arrival there. There was a little blood oozing from both openings; he was dull, but sensible, and complained much of a throbbing pain throughout his head. The ball having escaped, nothing was done for him, further than picking away some small loose fragments of bone, and applying wet dressing. He was freely purged, and got no food. In twenty-four hours the pain in the head having greatly increased, and being accompanied by delirium, with rapid pulse, ferrety eyes, and hot skin, he was largely bled, and cold was a]>] died to his head.