The Surgery of the Skull and BrainRawling, Louis Bathe
Science
The Surgery of the Skull and Brain
Rawling, Louis Bathe
Brain -- Surgery; Skull -- Surgery
The difficulties attendant on all attempts at following up hospital
cases are considerable, and consequently we are greatly indebted to
Crisp English[36] for his tabulation and discussion on the after-history
of 300 cases treated at St. George’s Hospital--300 cases personally
investigated at periods varying from one to twenty years subsequent to
the time of the injury.
English’s conclusions have been compared with those derived from my own
personal experience, with the result that they were found to coincide so
closely that they may be accepted as affording an accurate guide into
the remote results of head-injury in general.
English classified his cases into three series--each 100 in
number--according to the severity of the lesion.
Series 1. Fracture cases.
Series 2. Cases of concussion, contusion, and laceration.
Series 3. Miscellaneous cases.
The remote results as observed in the first and second series were as
follows:--
Series 1. No effects 31
Slight effects 50
Marked effects 19
Series 2. No effects 48
Slight effects 42
Marked effects 10
In the 200 cases, therefore, that come under Series 1 and 2, 79
experienced no ill effects from the injury, 92 developed slight effects,
and definite defects were present in 29 cases.
Before alluding further to the mental and bodily condition of the
patients subsequent to the accident, including their wage-earning
capacity, it is necessary to enlarge on the fact that the depreciation
in mental and physical faculties depends, not only on the severity of
the injury, but also on the age, disposition, and status of the patient.
_The effect of age._ All evidence tends to prove that head-injuries in
the young and the old are more serious than when the accident occurs
during middle life. In the old, the power of repair is impaired; in the
young, the developing faculties are impeded in their progress.
_The effect of disposition._ The temperament of the patient must always
be taken into consideration, the neurotic type seldom recovering so
quickly or so completely as the more plethoric.
Public-domain text, read in full here on John Shaqi.
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