Page:Recovery from the passage of an iron bar through the head.djvu/19

Rh II. This case has been cited as one of complete recovery, it being often said that a very considerable portion of the left cerebrum was lost, without any impairment to the intellect. I think you have been shown that the subsequent history and progress of the case only warrant us in saying that, physically, the recovery was quite complete during the four years immediately succeeding the injury, but we learn from the sequel that ultimately the patient probably succumbed to progressive disease of the brain. Mentally the recovery certainly was only partial, his intellectual faculties being decidedly impaired, but not totally lost; nothing like dementia, but they were enfeebled in their manifestations, his mental operations being perfect in kind, but not in degree or quantity. This may perhaps be satisfactorily accounted for in the fact that while the anterior and a part of the middle lobes of the left cerebrum must have been destroyed as to function, its functions suspended, its fellow was left intact, and conducted its operations singly and feebly.

III. Little has been said in the foregoing account as to the treatment or conduct of this case, this being regarded as quite unnecessary. The initiatory treatment, received from the iron, though it might not be well received in this presence, you will permit me to say, was decidedly antiphlogistic, a very large amount of blood having been lost. May we not infer that this prepared the system for the trying ordeal through which it was about to pass? The recovery is attributed chiefly to the vis vita, vis conservatrix, or, if you like it better, to the vis medicatrix naturæ, of which this case is a striking exemplification.

I desire to call your attention, in passing, to two critical periods in the progress of the case, when what was done undoubtedly changed the tendency to a fatal result. The first was on the fourteenth day, when the large abscess, which probably communicated with the left lateral ventricle,