Craniectomy for idiocy with notes of a case / by T. Telford-Smith.

  • Telford-Smith, Telford.
Date:
[1897]
Catalogue details

Licence: Public Domain Mark

Credit: Craniectomy for idiocy with notes of a case / by T. Telford-Smith. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    Two years after operation.— He does not knock his heao nor cry out. On the other hand there is no improvement i his speech; his vocabulary has not increased, and he sti slavers, and he is, as far as I can see, a restless and,. fear, a hopeless case of idiocy. The similarity between the symptoms of head-knockinr and crying out in these two boys N. L. and R. H., before tW operations, and the cessation of these symptoms afterward: is remarkable, and probably has a pathological foundation In both patients this is certainly a great improvement c their former state, but one would hesitate before sayin: there was an increase of intelligence. A mind has not bee created. What this improvement is due to would be difficult to 88 without a macro- and microscopic examination of the braini as well as an examination of the skulls ; that it is due totl relief of pressure could, perhaps, be accounted for in tl case of E. H. by the supposition that this pressure wr caused by subdural haemorrhages, which probably took plat during labour, and their after-effects. That there has inbo^ cases been relief of irritation of some kind seems high- probable, but whether this irritation was inside the ski (brain) or outside the skull (scalp) is a question of intere? That the improvement is due to a profoundly disciplina; effect upon the idiot,* or that it is largely through i pedagogic influence that an improvement in these cas: takes place, and that an operation is allied in its effect to severe piece of castigation, seems an hypothesis which, say the least, is beyond the ordinary range of patholog and would be difficult to prove by any ordinary methods research. As to the actual dangers of the operation, there is no dou that these are now very small, the two great risks hyperpyrexia and of shock being avoided by the method performing the operation in sections, and only excising small portion of bone at each sitting, and by taking carer to bruise the subjacent brain substance or interfere with t cortical thermotaxic centres in the cerebrum. * Craniectomy for Idiocy and Imbecility, by Cbarles L. Dana, M Pediatrics, March 15th, 1896.