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"The doctors say that they would suppose it was a fractured skull, or concussion of the brain, or something like that; but they've examined him and there is nothing to see on the outside; and they trephined and it didn't do any good; so they just let him stay about the hospital."
Upon incision of the prolapse intra-ocular hemorrhage occurred, causing nearly total blindness for two weeks. Vision is clearing fast and it remains yet to be seen what the final results may be. One buphthalmic eye trephined by myself gave good results.
The boy was trephined, and the comminuted fragments removed; in about six weeks recovery was nearly complete. Gibson reports the history of a girl of eight who was caught by her clothing in a perpendicular shaft in motion, and carried around at a rate of 150 or 200 times a minute until the machinery could be stopped.
Lannelongue made a long incision below the knee which let out a large amount of pus; the tibia was found denuded for a long distance. Three places in the bone were trephined. From each of these, quantities of pus flowed. Pus from inside and outside the bone was collected with all possible precautions and was carefully examined and cultivated later.
It may be called for later if the limb is likely to be useless, as, for example, when the whole shaft of the bone is dead without the formation of a new case, when the epiphyses are separated and displaced, and the joints are disorganised. Flat bones, such as the skull or ilium, must be trephined and the pus cleared out from both aspects of the bone.
The operation was sometimes performed upon animals. Shepherds trephined sheep for the staggers. We may say that the modern decompression operation, so much in vogue, is the oldest known surgical procedure. OUT of the ocean of oblivion, man emerges in history in a highly civilized state on the banks of the Nile, some sixty centuries ago.
Sensation in both extremities had slightly improved, and he was able to slightly move the toes of the right foot. This being his condition, an operation was proposed as the only means of further and permanent improvement, and to this he eagerly consented, and, accordingly, on the 25th of August, the 9th dorsal vertebra was trephined.
Suppose he had never been trephined, when would his consciousness have returned? When his breath ceased and his heart stopped beating? When Mr. Bernard said to Helen, "I have been dead since I saw you," it startled her not a little; for his expression was that of perfect good faith, and she feared that his mind was disordered.
Hammond reported a case of a young man who was the subject of merycism, and whose mental condition was also impaired. No special treatment was undertaken, but the patient was trephined, with the purpose of improving his mental condition.
In India I have gone farther than this, and where one eye has shown high tension, I have frequently trephined both. The prophylactic use of the operation is more than justified in that land of long distances and scattered medical aid, and where the patient is not likely to return a second time for surgical help.
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