Evening star. [volume] (Washington, D.C.) 1854-1972, 1904-08-06
A BROKEN SKULL.
Injury Mistaken for Intoxication by
Ambulance Surgeon.

Ambulance Surgeon.
From the New York Herald.
1t seems quite inexcusable that the or
binary ambulance surgeon should SO often
mistake a fractured skull for drunken
ness. Another case in point is that Of
respectable woman who, after having been
beaten by ruffians and when In dying
condition. was locked In cell on a charge
of intoxication, based on the careless and
hasty opinion of one Of these medical
youngsters.
1t was only by the merest accident-that
a policeman knew more about the symp-
toms of inebriety than the doctor-that an
other examination was demanded and the
unfortunate victim of violence was allowed
to end her life in hospital.
The objectionable error of the first dag
nosis was committed In the face Of the
fact that there existed a severe wound on
the head which was proved at the autopsy
to have been the cause of death.
The Herald has always contended that
in all suspicious cases OF brain injury even
the common drunkard should be given the
benefit of every doubt as to the cause of
his insensibility. 1t is, in fact, a question
of humanity that every helpless person
should run no risk when picked up In the
street of being sent to a cell rather than a
hospital bed.
The rule should be that all such cases
should not be trusted to the professional
opinion of mere tyros in the medical art,
but be taken to the accident ward and there
properly examined by experts. This would
require very little time or trouble, and
would effectually prevent the deplorable
mistakes in such cases which are occurring
so frequently.
men as class. The majority of them per-
form their duties with great credit to them
selves, but of the arrogant, staggering and
assertive incompetent there Is no form Of
criticism too severe. If he cannot be sup
pressed he should be watched.
Drunkenness is, unfortunately, such a
common condition that there Is little, II
any, reason for confounding- 1t with head
injury, with which II may be fgnorantly
associated by the inexperienced person. 1t
Is true that both phenomena may exist
but they should be differentiated without
difficulty by any competent medical exam
iner In any event there Is no reason for
any hurry in making the diagnosis.
The presence OF a confusion or lacera-
ton of the scalp, a depression Of the con-
tour of the skull at the site Of injury. the
unequally dilated pupils, the paralysis Of
the limbs from brain pressure, the surgical
shock of the raumatism and the slow.
unequal pulse all point to serious brain
difficulty and should be carefully noted.
Especially should such symptoms be sig
nificant when there is an absence of the
odor of liquor in the breath and when the
victim fails to respond to the various means
that may be used to temporarily arouse
him from his stupor.
But It seems so easy for the careless and
thoughtless ambulance surgeon to neglect
the proper examination. and SO convenient
to rid himself of an apparently troublesome
case that 1t Is almost wonder that mis-
takes do not come more frequent to light.
The necess..y, also, for accurate and
prompt decision In suspicious cases Is en-
phasized by the urgency Of surgical inter-
ference to prevent death by the cumula-
tive pressure upon peculiarly intolerant
organ. All these facts should certainly be
appreciated before the coroner comes on the
scene and makes evident by his verdict
another instance Of gross dereliction Of
professional duty.