A young sailor, about twenty years of age, in running hastily out from below deck, struck the crown of his head with great violence against a beam. -- He was stunned with the blow, but after a few minutes, was able to go about his business, and continued apparently well for three or four days, when he complained of a giddiness and pain in his head, attended with a slight fever. Under these circumstances, I was applied to for assistance, and, after enquiring into the history of the case, and examining his head, where no appearance of contusion was observable, I took sixteen ounces of blood from his arm, gave him a gentle purge, and ordered a low diluting diet, which soon removed all his complaints, and he continued perfectly easy for ten or twelve days, and were as speedily relieved by the same remedies.
--- In short, he continued to suffer attacks of pain in his head with a fever, every twelve to fourteen days for near three months, and was often relieved by gentle evacuations, until the eightieth day from the accident, when he suddenly became perfectly frantic and delirious, with a hard quick pulse, and most of the symptoms usually attendant on an inflammation of the dura mater.
---A copious bleeding, and several glysters afforded him very little relief, and as his situation was then to the last degree threatening, I was induced to examine the scalp with great attention, and thought I was sensible of some small degree of thickening on the part, where he first struck his head, and which he always pointed out, while sensible, as particularly painful :
Upon this I made two semi-circular incisions, and removed a sufficient portion of the scalp, with the pericranium, which adhered pretty firmly ; --- then perforating the bone, and taking out a circular piece, I was suprized to find only a slight degree of inflammation upon the dura mater, which I immediately divided with the point of a lancet, but without any discharge of blood or matter ;
---- all his dangerous symptoms disappeared the next day, returned no more, and he was cured in the usual time, without any other remarkable circumstance.
Taken mostly from "Plain concise practical remarks on the treatment of wounds and fractures" By John Jones, M. D. Published in Philadelphia: Printed and Sold by Robert Bell in Third Street, 1776
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