Seventeenth-century English surgery: the casebook of Joseph Binns
Christopher Lawrence in Medical Theory, Surgical Practice, 2018
Head wounds – particularly those involving fractures – were among the most serious disorders Binns treated. Of the thirteen cases for which we have some details, four patients died, five got well and four case-notes were incomplete, so the outcome is unknown. The four patients who died experienced a similar pattern of symptoms. Each seemed reasonably well after the initial dressing of the wound and remained so for at least a week. After between nine and fourteen days each patient developed symptoms – vomiting, fever, or paralysis – which became increasingly severe until the patient’s death between thirteen and twenty-five days after injury.51 In three cases, Binns and the other surgeons consulted followed standard procedure by laying the cranium bare in order to determine whether the skull had been fractured. In two cases the trepan was applied.52 In Binns’s practice this operation was obviously reserved for the most desperate cases, when the patient was expected to die in any event. Both of Binns’s patients who underwent trepanning died within 24 hours after the operation.
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Anton Sebastian in A Dictionary of the History of Medicine, 2018
Skull [Middle English: skulle, cranium] The Cannstadt skull, found in 1700, was one of the earliest of a primitive man. Peter Camper (1722–1789), a surgeon at Leiden, attempted to measure the skull from an anthropological viewpoint. Craniology, study of variation of skull in relation to race, was established by Friedrich Blumenbach (1752–1840) of Gottingen in 1775. Several Neolithic skulls were found in Brittany and other parts of France around 1870. Evidence for primitive man, Australopithecus, believed to be three million years old, was found in the Rift Valley in South Africa in 1925. Phrenology, study of the external form of the skull as an indicator of mental powers and moral qualities, was established by Franzjoseph Gall (1758–1828), German physician, and Casper Johan Spurzheim (1776–1832). Paul Broca (1824–1880) founded anthropometry with his invention of 27 craniometric and cranioscopic instruments. Trepanning is the oldest form of neurosurgery and 19 skulls with trephine holes, from the pre-Incan period were identified by Muniz in 1894. A Neolithic skull with a trephine hole was found in the river Thames in 18 64. The calvarium and femur of a primitive man, Pithecanthropus erectus, was discovered by Eugene du Bois (1858–1940), surgeon in the Dutch army while stationed in Java in 1893. Books on comparative anatomy in relation to anthropology include: Tabulae Craniorum Diversaurum Gentium by Sandifort (1830), Crania Americana (1839) and Crania Egyptiaaca by Morton (1844), Atlas de Cranioscopie (1845) by Gustav Carus, and Crania Britannica (1856) by Davis and Thurnum. See Piltdown man.
A brief history of Western medicine and healthcare
Emmanuel Tsekleves, Rachel Cooper in Design for Health, 2017
Archaeologists have established that the surgical procedure of trepanning, drilling a hole in the skull to relieve pressure on the brain, was practiced 10,000 years ago when the only tools available were made of sharpened stone. It is fascinating to speculate on the events and ideas that led people to fashion a tool to invade a skull in this way. Whatever the genesis of the practice it is notable that people still undertake it outside mainstream medicine and claim great benefits from a spiritual and wellbeing perspective (Dobson, 2000) as well as an approach to specific illness.
An innovative hippocratic cranial intervention for amaurosis in classical Greece
Published in Acta Chirurgica Belgica, 2021
Gregory Tsoucalas, Spyros N. Michaleas, Panagiotis Sideris, Marianna Karamanou
The Corpus Hippocraticum, edited by Littré, discusses amaurosis and its surgical treatments. In a section titled, ‘On Vision’ (Greek: Περί Όψιος, which was translated by Fréderic Jules Sichel (1802-1868), a French physician, ophthalmologist and friend of Littré), medico-philosophers of the Hippocratic school discuss people afflicted by amaurosis and suggest a trans-cranial surgical procedure in the area of the temporal bones: ‘If a person with healthy (intact) eyes presents with loss of vision, in this person you should perform an incision in the temporal cutaneous area. You should remove the skin and saw the cranial bone and remove the fluid which caused high pressure in the orbital area and thus blindness’ [3]. This book is dated in the late fifth–early fourth century BC, presenting the knowledge of that era in ophthalmology as well as previous hallmarks in the same field [13]. The surgery was conducted using a trephine, a surgical instrument used for boring holes. Various types of trephines and surgical probes (Figure 1) existed during this period, and many trepanation procedures likely were performed in the Hellenic peninsula and Aegean islands, indicated by human remains showing signs of skull regeneration. Surgeons who performed trepanning were careful to protect all anatomic structures such as the meninges and the bone tissue in order to be able to distinguish and separate them from the cutaneous layers (Figure 2) [14]. Instructions for cleaning the wound were as follows: ‘If there is a cavity beneath, it ought to be incised clear around with a circular incision, or half-way around, to an extent corresponding to the nature of the case. In every case with complications (erysipelas, pus, oedema, infection-greenish tissue), the area should be cleaned out in the direction most suitable to the particular cases, either upwards or downwards’ [15].
The influence of Arabic medicine on surgery in the Low Countries1
Published in Acta Chirurgica Belgica, 2020
Fijens advises Albucasis’ s burning by a circular hot iron to open the skin and gallea,41 freeing the surface of the skull, so as to easily use the modiolus for piercing the bone. Hereby does the use of a security type of trephine, named ‘ababtista’ by the Arab scholars, offer the least chance of damaging the cerebral membranes.42 As well after successful trephining as after scraping the skull, the wound is cleansed and closed over the bony opening.
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