THE INDIAN MEDICAL GAZETTE.
320
A MIRROR OF HOSPITAL PRACTICE. BAREILLY DISPENSARY,
Under
the
Care of Surgeon-Major R. C. Sanders, M.D., F.R.C.S. E.
Two Cases of Severe
Injury
io
the Head.
The following cases of injury to the head were treated within a short time of each other ; recovery after such severe injury is The history of the first case was peculiar. The woman rare. and her husband were sleeping together, when they were suddenly attacked by two police sowars armed with swords. The man was cut to pieces, and died from haemorrhage whilst he was being brought to the dispensary ; the woman when admitted had sustained the following injuries:? Case i.?Mussamut Anondy, aged 18, a handsome Hindoo lady, was brought to the dispensary at 12-30 A.M., on the 10th November, 1881, suffering from? 1st ?An incised wound 2 inches long by % in. broad, on the left side of the head, extending through the skull. 2nd.?An incised wound 5 inches long, 1 inch broad, on the left side of the head, extending backwards from the forehead to the upper part of the left ear, and cutting through the skull. yd.?An incised wound 6 inches long, ^ in. broad, parallel to the above cutting through the parietal and fiontal bones, dividing the dura mater and exposing the brain, two pieces of the frontal bone, one small, the other 2 inches long by 1 inch broad, were found quite loose and were removed. 4th.?An incised wound about 1^ inches long by ^ in. in. deep on the left shoulder. broad, and in. broad by 5th.?An incised wound 3 inches long by 1 \]/z in. deep, on the upper part of the left arm, dividing the deltoid muscle, and partly cutting through the head of the humerus. 6th.?The first phalanx of the left index finger nearly cut oft", merely hanging by skin. The woman was insensible from loss of blood when admitted. The head injury was treated with cold water, and the other wounds were sewn up and carbolised oil applied, the finger was put on a splint and kept in fair position ; good union without motion resulted. 11 th November.?Feverish and restless, pallid from loss of blood, complains of much pain in the head; ordered Tinct. aconiti Liq. ammon. acetat, Spt.* nit. ether 7^10, water ad.
?fl^3,
?i
to
be taken every hour.
7^30,
12th November.?Free from fever, head pain severe, sensible but faint, pulse very feeble, aconite stopped. ijth November.?Going on well, pain in head less, bowels costive ; to have a dose of comp. rhubarb powder. 18th November.?Wounds all looking healthy, no pain complained of, pulse very quick, 120, skin cool ; from this date she slowly recovered, but her pulse remained quick up till the date of her discharge, 3rd January, 1882, when the wound in the head had entirely healed. A few thin spiculae of bone came away from the wound in the head at the latter part of December. Case I i.?TikaRam, a Hindoo male, was admitted on the 23rd April, suffering from compound fracture of the frontal bone ; on the left side of the frontal bone was seen a contused and lacerated wound, and the bone could be seen to be fractured and depressed, the skin around the wound was erysipelatous and puffy. The man was sensible, but dull and restless, when spoken to in a loud voice replies, states this is the third day since he was hurt. 24th April, 1882.?Only mutters indistinctly when spoken to, erysipelatous swelling much increased, eyes puffy, left eye closed, both eyes blackened from intraorbital hemorrhage, skin hot, pulse quick and irritable. The man was placed on the operating table, the fracture exposed by a crucial incision and the trephine applied about one inch from the coronal suture and a little more than a semi-circle of bone removed. After trephining, the depressed bone could be easily raised by an elevator. Three loose pieces were removed, the dura mater was found to have been torn by these spicula:. 25th April.?Much brighter, complains of slight pain in the found head, sitting up in bed, has taken a little food. 27th April.?Going on well, swelling less, no pain, wound looking healthy, the brain pulsation can be distinctly seen. From this date the man steadily improved, the wound slowly contracted and had healed on the 30th May, 1882, when he was discharged, cured.
[December,
1882.
320
A MIRROR OF HOSPITAL PRACTICE. BAREILLY DISPENSARY,
Under
the
Care of Surgeon-Major R. C. Sanders, M.D., F.R.C.S. E.
Two Cases of Severe
Injury
io
the Head.
The following cases of injury to the head were treated within a short time of each other ; recovery after such severe injury is The history of the first case was peculiar. The woman rare. and her husband were sleeping together, when they were suddenly attacked by two police sowars armed with swords. The man was cut to pieces, and died from haemorrhage whilst he was being brought to the dispensary ; the woman when admitted had sustained the following injuries:? Case i.?Mussamut Anondy, aged 18, a handsome Hindoo lady, was brought to the dispensary at 12-30 A.M., on the 10th November, 1881, suffering from? 1st ?An incised wound 2 inches long by % in. broad, on the left side of the head, extending through the skull. 2nd.?An incised wound 5 inches long, 1 inch broad, on the left side of the head, extending backwards from the forehead to the upper part of the left ear, and cutting through the skull. yd.?An incised wound 6 inches long, ^ in. broad, parallel to the above cutting through the parietal and fiontal bones, dividing the dura mater and exposing the brain, two pieces of the frontal bone, one small, the other 2 inches long by 1 inch broad, were found quite loose and were removed. 4th.?An incised wound about 1^ inches long by ^ in. in. deep on the left shoulder. broad, and in. broad by 5th.?An incised wound 3 inches long by 1 \]/z in. deep, on the upper part of the left arm, dividing the deltoid muscle, and partly cutting through the head of the humerus. 6th.?The first phalanx of the left index finger nearly cut oft", merely hanging by skin. The woman was insensible from loss of blood when admitted. The head injury was treated with cold water, and the other wounds were sewn up and carbolised oil applied, the finger was put on a splint and kept in fair position ; good union without motion resulted. 11 th November.?Feverish and restless, pallid from loss of blood, complains of much pain in the head; ordered Tinct. aconiti Liq. ammon. acetat, Spt.* nit. ether 7^10, water ad.
?fl^3,
?i
to
be taken every hour.
7^30,
12th November.?Free from fever, head pain severe, sensible but faint, pulse very feeble, aconite stopped. ijth November.?Going on well, pain in head less, bowels costive ; to have a dose of comp. rhubarb powder. 18th November.?Wounds all looking healthy, no pain complained of, pulse very quick, 120, skin cool ; from this date she slowly recovered, but her pulse remained quick up till the date of her discharge, 3rd January, 1882, when the wound in the head had entirely healed. A few thin spiculae of bone came away from the wound in the head at the latter part of December. Case I i.?TikaRam, a Hindoo male, was admitted on the 23rd April, suffering from compound fracture of the frontal bone ; on the left side of the frontal bone was seen a contused and lacerated wound, and the bone could be seen to be fractured and depressed, the skin around the wound was erysipelatous and puffy. The man was sensible, but dull and restless, when spoken to in a loud voice replies, states this is the third day since he was hurt. 24th April, 1882.?Only mutters indistinctly when spoken to, erysipelatous swelling much increased, eyes puffy, left eye closed, both eyes blackened from intraorbital hemorrhage, skin hot, pulse quick and irritable. The man was placed on the operating table, the fracture exposed by a crucial incision and the trephine applied about one inch from the coronal suture and a little more than a semi-circle of bone removed. After trephining, the depressed bone could be easily raised by an elevator. Three loose pieces were removed, the dura mater was found to have been torn by these spicula:. 25th April.?Much brighter, complains of slight pain in the found head, sitting up in bed, has taken a little food. 27th April.?Going on well, swelling less, no pain, wound looking healthy, the brain pulsation can be distinctly seen. From this date the man steadily improved, the wound slowly contracted and had healed on the 30th May, 1882, when he was discharged, cured.
[December,
1882.
