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Show A REMARKABLE CASE. A most remarkable case in surgery has been developed at the United States Marine Hospital here. It is one of those rate cases that disobey the laws of the yellow-back books, and effectually puzzles the doctors. During the labor riots of 1873 a mulatto? named Jones, who is now 36 years old as struck on the crown of the head with a club, and his skull was badly fractured. This occurred in the interior of the State of Ohio. For several days the man was unconscious, but in six months time he had recovered sufficiently to go to his work. Soon after this, however he began to complain of severe pains in the place where the fracture occurred; the pains grew worse, and finally Jones became subject to epileptic convulsions which continued until two years had elapsed from the time of the original injury. At some small town in Ohio the operation of trephining, or boring a hole in the skull, was performed, and the depressed bone removed. Jones was entirely relieved by the operation, and soon afterwards he went to work as a roustabout on a steamboat. In 1878, three years after the trephining, he began to complain of the same pains which followed the original injury. The pains gradually became almost unbearable, and epiletic [epileptic] convulsions again occurred. In this condition on the 10th of January, 1880, the man was admitted to the Marine Hospital here, and Dr. W. H.? Long, the surgeon in charge, undertook his case which was diagnosed as one of pressure on the brain, caused by the bone having reformed over the opening made by the trephine. The new bone was cup-shaped, with the convexity pressing on the delicate tissues of the brain. The man was almost a skeleton and suffered intensely. In March he was again trephined, and the convex piece of bone was removed. The trephining as done at the seat of the former operation, and gave instant and complete relief. But in about four weeks the pains were renewed at the spot of the trephine, and a small quantity of puss [pus] was discharged through the scalp. This state of affairs continued about two weeks, when Dr. Long made an incision in the site of the wound and it was discovered that the piece of bone was loose in the brain. The bone was removed, and found to be about two inches long, one and three quarters inches broad and very thick. The smooth internal and external plates of the bone had been almost entirely absorbed by the brain, and the piece of bone had been eaten away until it had become honey-combed. On one side the bone bore about one-quarter of the circle made by trephining. Dr. Long supposes that when Jones was struck the bone had been fractured, but had been held in its proper position by the other bones of the skull. In the operation at trephining the bone had been further loosened [???several lines illegible???] When it was removed the sufferer became relieved from all pain and the wound rapidly healed. But the man's ills were not over; in a short time he began to complain of a violent pain in the back part of the head, and the scalp became elevated and seemed to contain pus. It was opened deeply, but not a drop of pus was found. As the continued it was finally determined to cut down the bone. Consequently in the latter part of May the man was put under the influence of chloroform, and a conical incision, four inches broad, was made over the seat of the pain in the prominent part of the portion of the skull. It was found that here the external table of the skull in a space of more than four inches had been entirely absorbed, leaving the bone in a rough state?, the cellular structure being exposed to view. The surface was well scraped and the wound was dressed. Since that time there has been no return of pain, and the wounds are entirely healed. Jones has gained more than twenty-five pounds in weight, and for the first time in many months is able to be out of doors and at work. The most curious feature of the case is that, notwithstanding the immense amount of damage done to the external plate of the skull in posterior part of the head, not a single drop of pus ever ran from the place. There is no history of syphilis in the case, or it would be easy to account for the absorption of the bone. As it is, however, it cannot be accounted for. When the scalp was cut it was found that it was three-quarters of an inch thick. This unusual thickness supplies the place of the bone in the skull, where there is an opening made by the piece which was taken from the brain. The bone will, in all probability, never form over the opening, but a siccatrical?? tissue as formed there. Jones is about able to return to his work as a roustabout, and will leave the hospital in a few days. - Louisville Commercial. |
