Page:The growth of medicine from the earliest times to about 1800.djvu/525



the bone. The latter was found to be fractured transversely and depressed; and, in order to lift it back to its proper level, it became necessary first to incise the muscle transversely. At the end of three months the wound had completely healed and the patient had regained his health.

Speaking of the cases just narrated and of others of a similar nature, Leone remarks that he has never had any experience that would justify the fear expressed by Hippocrates that convulsions are likely to result from dividing the temporal muscle.

With reference to the value of trephining the skull in cases of injury to the head, Leone narrates the following experience:—

Case III.—A man was struck by a heavy stone on the upper part of the forehead close to where the hair grows, and was thrown to the ground by the force of the blow. Here he lay as if dead. When Leone was called, a short time afterward, to see the patient he found the skin unbroken except at one small spot, and from this point he made an incision of such length that he was thereby enabled to explore the surface of the skull. In this way he discovered that there was a fracture which appeared to extend through the entire thickness of the skull. He then, without further delay, trephined the cranium over the line of the fracture. This was followed by such a copious flow of blood that Leone was obliged to adopt measures for arresting any further hemorrhage. During the following fourteen days (the summer season then being at its height) large quantities of decomposed and evil-smelling blood escaped from the wound; but the dura mater gradually assumed a more natural appearance, many splinters of bone were ejected, and finally—at the end of forty days—the wound healed. (As no further details are given in the text, it is fair to assume that there were no sequelae of an unfavorable nature.)

The whole subject of injuries to the skull is treated in a most thorough manner by Leone, and the book is pronounced by Scarpa (1752-1832), the famous anatomist, the best that, up to his time, had been written on the subject. The three histories of cases which I have here reproduced and which furnish such striking proof of what surgery may accomplish when practiced by a man of good courage