Identifier: manualofmodernsu1899robe (find matches)
Title: A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners
Year: 1899 (1890s)
Authors: Roberts, John B. (John Bingham), 1852-1924
Subjects: Surgical Procedures, Operative Surgery
Publisher: Philadelphia : Lea Brothers & Co.
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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s insensible to light. Pupils react somewhat to light. 9. Deglutition impossible. Deglutition possible. In the absence of a history of the patient before unconsciousnessoccurred, it is frequently difficult and sometimes impossible to discrimi-nate between coma due to compression of the brain, alcoholic ornarcotic poisoning, ursemia, apoplexy, sunstroke and hysteria. Anunconscious man with bruises upon the head, picked up in the streets,may be suffering from brain compression due to injuries receivedwhile intoxicated; or may have fallen from an elevation becauseof an apoplectic seizure or sunstroke, and thus have sustained second-arily a depressed fracture of the skull. In such cases the head shouldbe shaved, and careful examination made for signs of injury to theskull; the urine should be examined for albumin and tube casts, alco-hol, opium and. other poisons ; the temperature should be taken, andtests of electro-muscular sensibility and contractility should be insti- PLATE IV. FIG.I.
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Fig. 1. Compound Fracture of Cranium, with Depression ; Fracture ofBones of Face; Extradural Clot from Rupture of Middle Meningeal Artery. Fig. 2. Horizontal Section of same, showing Depressed Fracture ofBone; C, Extradural Clot; D, Laceration of Brain-substance, with extensiveIntracerebral Clot; F, Same condition produced by Contrecoup. Punctate Hem-orrhages and Minute Lacerations at Numerous Points, characteristic ofContusion of the Brain. (Anger.) TUMORS OF 1HE BRAIN. 215 tuted. The ophthalmoscope will sometimes be of service in disclosingalbuminuric retinitis, choked disk or other changes in the fundus. The existence of paralysis in compression of the brain usuallyserves to distinguish it from the conditions named, with the exceptionof apoplexy. It is the compression produced by the hemorrhage inan apoplectic seizure that induces many of the symptoms; hence, adiagnosis is impossible unless the history and evidences of injuryafford direct information. The treatment, however, is ide

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