He was, however, unable to speak. Dr. Willis saw him about this time, and found a semiluiiiir wound, about nine inches long, extending over the left side of the head, and curving over the ear. The flap of the scalp hung down over his ear, and a clot of blood covered the bone. On clearing away this mass of effused blood, the bone was found to be comminuted and depressed in an irregular crescentic shape, to the extent of four inches long by two broad. It was driven downwards to the depth of a quarter of an inch, and comprised part of the frontal and a portion of the parietal bones. The flap of the scalp was cleaned and replaced, and cold applied.
Nothing else was done that IN.M LD. M<>iv difficulty I T tin- treatment <>f the second rivd to In-fore, tlmsc in whieh there bctare with depression, attended immediately by which an- usually said tlved. But yet, with all that '1 on the subject, in books and lectures, (juestion whether wt are sufficiently acquainted with the nature, or sipis of compressioi i, to warrant us;ig. His pupils remained unaffected at all times, and his pulse never was much disturbed, but at the evening visit his mouth was found drawn to the left side. Next morning at ten o'clock, the speechlessness remained, but no new symptoms were added.
The fractured bones were so firmly impacted that they could not be removed without the u>e l.r.iin, blood flowed from between the skull and tinmeml>rane. Whenever the depressed fragments were removed, the tongue could truded, which before the operation it u< The speech did not return. The scalp was replaced and he was purged, and j-ut.M low diet, ami kept quiet, cool, and in th. night he had again lost all: his tongue, but recove morning, and from that period his convalescence went on so rapidly, that in three weeks his wound had completely < -ic.itri/ed; 1: 1 an uneasy feeling, and returned in perfect health to his work vithin six weeks of the period when he met the accident.
I saw him, il. of 1'r. Willis, some time afterwards. He told me he never had had a headache.-ineen dnuik. The cieatrix was firm, ai My >nnk. tinl>rain pulsations could be obscurely felt at one comer. i tlit the base An we in cases of doubt to proceed as Heistcr directs? " Sometimes it is impossible," he says, " to discover the particular part t urgent and dangerous symptoms.
In these cases it will be necessary to trepan first M BUBGBBT OF Tin: CI;IMI:AN WAR. in undertaking, at an early period at any rate, an operation of so serious a description, as all recorded experience has shown tn-pl lining to be, without more reliable and more rloarly-defined evidence of its presence than is commonly thought to denote it. Symptoms which, by the dicta of books, were unquestionably those of compression, have passed off, in the experience of every one, under a treatment of which non-interference was the most important item; while in other cases such large quantities of fluidblood and pus have been found, post mortem, on the brain, as all recorded experience tells us should have caused a compression which yet never appeared.