DOI Page / Citation link:
https://doi.org/10.11588/diglit.4812#0025
NERVOUS SYSTEM. 15
SECT. HI.
If, indeed, the water is situated between the dura mater and surface of
the brain, and of course between the spinal marrow and its Iheath from the
dura mater, a case which, I believe, occurs more rarely than is generally sup-
posed; or if, from a very evident ssu&uation, chiessy about the bregma, we
strongly suspect this to be the case, it will perhaps be adviseable to give the
patient the only, though small, chance of cure by operation*
In one case of a boy of three years of age, whom I visited in 1764, along
with Dr Grant and the late Dr Whytt, the head was greatly enlarged, with
all the ordinary symptoms of hydrocephalus. Dr Whytt, who had seen
several patients killed by a few ounces of water within the ventricles, and
had never seen the head sensibly enlarged by water lodged in the ven-
tricles *, insilled that the water mull be situated on the outside of the brain;
and, as I could not prove what I supposed, that it was within the brain, it
was agreed that a surgeon ssiould be called, and a punclure made. We
asked Mr James Rae to attend, and I proposed that the puncture ihould be
cautioussy made, not with a trocar, but with a lancet, at the outer side of
the bregma, as far as possible from the superior longitudinal sinus. The
ikin being accordingly first cut, and then the dura mater, and a probe in-
troduced, without discharging water, we desisted from making any farther
attempt.
The puncture soon closed, and the child survived three months. After
death, I opened the head, in presence of Dr Grant, and several other
gentlemen. We drew from the ventricles above two pounds of water;
and, on examining the communication between the lateral ventricles, it was
found
* See Dr Whytt's Works in 4*0, p. 728. Note f.
SECT. HI.
If, indeed, the water is situated between the dura mater and surface of
the brain, and of course between the spinal marrow and its Iheath from the
dura mater, a case which, I believe, occurs more rarely than is generally sup-
posed; or if, from a very evident ssu&uation, chiessy about the bregma, we
strongly suspect this to be the case, it will perhaps be adviseable to give the
patient the only, though small, chance of cure by operation*
In one case of a boy of three years of age, whom I visited in 1764, along
with Dr Grant and the late Dr Whytt, the head was greatly enlarged, with
all the ordinary symptoms of hydrocephalus. Dr Whytt, who had seen
several patients killed by a few ounces of water within the ventricles, and
had never seen the head sensibly enlarged by water lodged in the ven-
tricles *, insilled that the water mull be situated on the outside of the brain;
and, as I could not prove what I supposed, that it was within the brain, it
was agreed that a surgeon ssiould be called, and a punclure made. We
asked Mr James Rae to attend, and I proposed that the puncture ihould be
cautioussy made, not with a trocar, but with a lancet, at the outer side of
the bregma, as far as possible from the superior longitudinal sinus. The
ikin being accordingly first cut, and then the dura mater, and a probe in-
troduced, without discharging water, we desisted from making any farther
attempt.
The puncture soon closed, and the child survived three months. After
death, I opened the head, in presence of Dr Grant, and several other
gentlemen. We drew from the ventricles above two pounds of water;
and, on examining the communication between the lateral ventricles, it was
found
* See Dr Whytt's Works in 4*0, p. 728. Note f.