Pittsburg dispatch. [volume] (Pittsburg [Pa.]) 1880-1923, 1889-12-09
| SURGEONS KNIFE
Used to Prove a Philadelphia Doctors
Diagnosis Was Correct.
A VERY WONDERFUL OPERATION
The Exact Cause of EpiIeptic Fits in
Little Boy Plainly Seen.
EFFECTS OF ELECTRICITY ON A BRAIN
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ESPECIAL TELEGRAM TO THE DIsPATcH.i
PHILADELPHIA, December ga very
rare and important operation in surgery was
performed by DIR. W. w. Keen, Professor Oh
Surgery at the Jefferson Medical College,
Yesterday afternoon. 1t consisted in remoV-
ing diseased portion of ehild's brain, ior
the radical cure of epilepsy. A remarkaDle
feature of the case was the absolute eonnr-
nation of DR.. Keen's diagnosis.
The history of the patient, who is the
little 6-year-old son of prominent clergy
man in the interior of New York State, Is
interesting. The little fellow, when ABOUT
2 years old, while playing at home, fell ana
bumped his head rather severely, but az
first. after the temporary pain had passed
off no i'll effects were observed. After a
time the boy became subject to epileptlc
convulsions, and gradually lost the power
of speech, except words as ''pa" and ma
AS A LAST RESORT.
The parents consulted authority after
authority, and at last resolved to submit the
case to Prof Keen. The child was brought
here, and by Prof. Keen's directions was
put in charge of an intelligent nurse, VINO
had strict orders not to interfere during tne
convulsions, unless to save her patient nom
harming himself She was also ordered 70
preserve a strict account of all the move
ments. motions and expressions OF counte-
nance the patient underwent while IN a COIL
vulsion. A.
After a week of patient watching the
nurse rendered her report. The chlid' sne
said, while in an epileptic state, turned us
head to the right while its eyes glared 70
the left: the muscles of the right hand and
arm twitched convulsively, and the right
arm was drawn up in front of the face as IL
striving to protect the eyes. From these
symptoms DR.. Kean concluded that the
nerves located on the left side of the BRAIN,
Immediately over the Isle of Riel, was inter-
fered with and pressed upon by some lesion
situated there.
AN OPERATION DECIDED UPON.
After consultation it was decided-to op-
crate in hopes of removing the obstruction
and so curing the tendency to epilepsy. On
Saturday afternoon the little patient was
etherized and laid upon the operating table.
His head had been carefully shaved and
washed with an antiseptic solution. DR..
Keen, assisted by DR.. William Forbes and
DR.. Addinell Hewson, Jr., began the opera
tion. :, -,
After taking the length of the skull with
an instrument devised for the purpose, and
marking with an analine pencil line upon
the crown. running at an angleof about to de-
grees forward, and in the left Of the medlan
line DR.. Keen carefully separated the scalp
and turned it back, leaving the skull Gov
cred with the periosteum, perfectly bare.
Applying the trephine at two points on the
line. he removed two circular pieces OF
bone and enlarged the aperture thus made
with the bone forceps.
THE THEORY CORRECT.
All these pieces of bone were carefully
nlaeed in sterilized fluid at the temperature
of the human body-that is, about 1000
Fahrenheit. Now the quivering brain
covered by the dura mater was to be seen.
This being carefully divided, the diagnosed
lesion, right at the place supposed, was
found.l
At this point an experiment was made.
A galvahic battery was brought out, and ON
being applied to the cicatrix of the brain,
ali the phenomena of an epileptic attack
were simulated, confirming the surgeons
opinion that here was the seat of the trouble.
A few sklIlful, rapid and careful movements
of the knife followed, and in few moments
the mass of diseased brain substance was
successfully removed, and the, resulting
cavity carefully cleaned. On applying the
galyanic battery again no epileptic convul-
sion followed, much to the physicians de-
light
NO ALARMING RESULTS YET.
The work of closing the brain by replac-
ing :the dura mater, carefully sutured,
was begun, followed by replacing the bone,
and then the scalp. Over all this was skill
fully secured in place by antiseptic dressings
and bandages, and the little fellow restored
TO his neat cot. No alarming results fol-
lowed, and the result of the operation will
be watched with great interest by the pro-
fession