[p. 158]convulsions seize the other
side of the body; for, if the wound be situated on the left side,
the convulsions will seize the right side of the body; or if the wound
be on the right side of the head, the convulsion attacks the left
side of the body. And some become apoplectic. And thus they die before
the end of seven days, if in summer; and before fourteen, if in winter.
And these symptoms indicate, in the same manner, whether the wound
be older or more recent. But if you perceive that fever is coming
on, and that any of these symptoms accompany it, you must not put
off, but having sawed the bone to the membrane (meninx), or scraped
it with a raspatory (and it is then easily sawed or scraped), you
must apply the other treatment as may seem proper, attention being
paid to circumstances.
Part 20
When in any wound of the head, whether the man has been trepanned
or not, but the bone has been laid bare, a red and erysipelatous swelling
supervenes in the face, and in both eyes, or in either of them, and
if the swelling be painful to the touch, and if fever and rigor come
on, and if the wound look well, whether as regards the flesh or the
bone, and if the parts surrounding the wound be well, except the swelling
in the face, and if the swelling be not connected with any error in
the regimen, you must purge the bowels in such a case with a medicine
which will evacuate bile; and when thus purged the fever goes off,
the swelling subsides, and the patient gets well. In giving the medicine
you must pay attention to the strength of the patient. | The practice advocated in this paragraph is alluded to by Paulus AEgineta, in his chapter on Fractures of the Skull. (vi., 90.) |
Part 21
With regard to trepanning, when there is a necessity for it, the following
particulars should be known. If you have had the management of the
case from the first, you must not at once saw the bone down to the
meninx; for it is not proper that the membrane should be laid bare
and exposed to injuries for a length of time, as in the end it may
become fungous. And there is another danger if you
saw the bone down to the meninx and remove it at once, lest in the
act of sawing you should wound the meninx. But in trepanning, when
only a very little of the bone remains to be sawed through, and the
bone can be moved,
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