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Show "'OUNDS OF THE HEAD. es CONCUSSION. Of leach of these causes of death, I preserve specimens in 111113; :1?ulleiction to illustrate the pathology of this subject of 293;. here we have always to remember the remark of Mr. Hunter, that from a slight blow on the head, we find the membranes of the brain much oftener to suppurate than the ti- In reasoning on the symptoms produced by injuri es of the head, we should learn to distinguish betwixt the local and constitutional symptoms of disease of the bone and inte ments, and those which are the effect of disea se of the b gill itself; and in the second place, remember that the atle film of the brain itself, when it has once enter ed into diseased Iaocn tion, lrom an injury of the bone, is almost certa inly fatal and . i\,. \..-,. .‘-. up that}? we wait for the symptoms of a begin ning afl‘ecticn of hit: t; app), gogghall, 1n ninety-nine of a hundred cases, be too When I speak here of the diseased action of the brain I do not mean the simple effect of concussion, or the general state of excitement and action of the vessels of the brain nor yet of the influence of compression: these we may couhter: act. But I mean the derangement of the brain y-the a ~proach of local disease proceeding to the brain and H161: brancs; and this, although we may prevent, we cannot co: tron], after it has made any considerable progress. " lhc good sense and discrimination of \the surgeon is bia or fibula do from a similar blow on the shin. " These membranes of the brain appear to suppurate very readily, and with very little inflammation*." 0F CONCUSSION OF THE BRAIN. CONCUSSION is that disorder of the brain which is more or less the immediate consequence of every injury of the head from falls or blows. It is the effect of the vibration and percussion affecting the matter of the brain directly, and without the intermedium of the circulation. In a slighter degree it is marked by giddiness, dimness oi sight, weakness of the limbs, trembling, and nausea; and this every one has experienced. There is in this state more of disorder of sensation than of oblivion or dulness. There is less insensibility to pain than in oppression. When the brain sullers in a greater degree, the man becomes insensi- ble; his face is pale, his skin cold, his limbs relaxed, his therefore to be exercised in ascertaining what are the syinr breathing low and weak, the pulse feeble, and the pupil dilated, but not so remarkably as in compression. As the efl‘ects of toms of concussion ; of compression ; of the general state of iii {lamination of the brain; and of the partial inflammat ion of the violent concussion wear oh, the sensibility gradually returns, brain, with ulcer, a large coagulum oppre ssinc? the brain " fissures, and slight depressions of the skull aie distine‘uished by no symptoms, unless in so far as the dase resolve: into some of the foregoing. For example, immed iately after th" acc1dent they are attended with the svmptoms of concussionh and afterwards, perhaps, with general or partial inflanin‘a: itxon of the brain. But still these symptoms do not proceéé 1;th thevfi‘acflture ; they originate from the injury which the 1‘1] receivtd, at the same time that the bone was hurt. 'lhere IS another class of symptoms marking that disease of the brain, which arises slowly, and in process of time b‘» communication from the carious or fract ured bone; ant the pupil contracts, the pulse rises, the skin gets warm: the patient can be roused from his lethargy as from sleep, or sensibility returns at intervals; he awakes, answers ques- tions, and again relapses. Reviving, there is confusion of intellect, delirium, sometimes loss of memory ; the function of the stomach is deranged, and through the stomach, the 11% patio system also. In concussion there is an injury of the matter of the brain, as well as loss of sensation. In oppression, the injury is less general : it does not confound the simple effect of the insensibility, nor rouse the vascular action. " On the Blood, 53% WON! M09917! |
