The St. Louis Republic. [volume] (St. Louis, Mo.) 1888-1919, 1901-02-03

essarily be fatal from the widespread in
jury to the bones and the brain. But our
modern methods by which We can disinfect
the cavities of the ear. the nose and the
mouth. with which these fractures often
communicate and through these avenues
become infected, are so successful that such
cases. instead OF being looked upon as hope
less. are In a majority of instances followed
by recovery. Even gunshot wounds in
which the ball may remain inside the cavity
of the head are successfully dealt with. UNI
less the injury produced by the ball has
been necessarily fatal from the start. F1uh-
Ter OF New York has. reported a very re-
markable case OF gunshot wound In which
the ball entered at the forehead. traversed
the entire brain, was detected at the back
OF the skull and then pursued its course FUR
Their downward In the brain. BY trephining
the skull at the back OF the head he found
the ball. passed a rubber drainage tube
through the entire brain from the front to
back. and had the satisfaction of seeing the
patient recover.
Until 1884 1t was excessively difficult to To-
cate with any degree Of accuracy a tumor
within the brain, but in that year Doctor
Bennett of London for the first time accu-
rately located a tumor within the skull
without there being the slightest evidence
on the exterior of its existence. much less
Of its location. Mr.. G0dlee (surgeons in
England are not called doctor" but mt
tfcpulIteu Tie Skuil al the punt huuicdttNs
found the tumor and removed IL. True. this
patient died. but the possibility of accurate
ly locating a tumor of the brain, reaching
1t and removing it was now demonstrated,
which Is far more important TO humanity
at large than whether this individual pa
tent survived or not. Since then there has
been a very large number of tumors ste
c~essfully removed. The latest statistics are
those of Ven Bergman of Berlin in 1895.
He collected 273 operations for brain tu-
mors. OF which 1863 l61.9 per cent? recovered
and 13i t3S.1 per cent? died. This Is by far
the best percentage of results so far re-
ported. but there is reason to believe that
with the constant Improvement In our abil-
ity to locate such tumors and in our meth
DDS of removing them the mortality rate
will be further lessened.
Even more successful than the surgery of
brain tumors has been that Of Assesses of
the brain. / have no available statistics
OF the exact numbers. but II Is certain that
several hundred have been operated on and
with even better success than in the case of
brain tumors. The most frequent cause
for such assesses is old and neglected
disease Of the ear. No child suffering from
a running from the ear" which is espe-
cialiy apt to follow scarlet fever and other
similar disorders. should be allowed to pass
from under the most skillful treatment un-
til a cure is effected. This is the common
est cause Of abscess Of the brain. The In
Examination In the ear. which begins in the
soft lining Of the cavities Of the ear finally
extends to the bone. and after years OF in
termittent discharge will suddenly develop
an abscess Of the brain. which. II not re-
lieved. will certainly be fatal. Prompt SUR
gical interference alone can ave life. and.
happily. though we cannot promise recov-
cry In all. a very large percentage of Sue
cess Is assured.
In epilepsy as a result of injuries OF the
head. in a moderate number of cases. We
can obtain a cure of the disease by opera
tion. but in the great majority of cases.
and. one may say. practically in all Of the
cases in which the epilepsy originates "of
itself" that Is to say. without any known
cause. IL Is useless to operate. certainly at
least after the epileptic habit has been
formed. Possibly were operation done at
the very beginning we might obtain better
results than experience thus far has shown
us Is possible.
Very many cases of idiocy are constantly
brought to surgeons in the hope that some
thing can be lone for these lamentsble
children. Unfortunately. at present sur
gerry holds out hut little hope In such cases.
In a few exceptional instances IL may he
best TO operate. but a prudent surgeon will
decline to do any operation in the vast ma
jority OF cases.