Acute Gonorrheal Rheumatism

HOWARD LILIENTHAL
1895 Boston Medical and Surgical Journal  
factor in the success of an exploratory cranial operation. (4) In an exploratory operation, where it is not certain that a large extradural clot existB, look out for the middle meningeal artery. Remember that it runs in a deep groove on the inner surface of the cranium, and that iu trephining directly over it, unless the dura be separated in some way from the cranium, the artery is likely to be cut by the trephine before the bone has been completely sawn through. Again, remember how closely the
more » ... ber how closely the dura íb or may be attached to the inner surface of the cranium, and that in cutting with bone forceps in the course of the artery or its branches, great care must be taken not to tear or cut the bloodvessel. (5) It is perhaps scarcely necessary to mention that all cases of intracranial hemorrhage with which the surgeon has to deal (that is, all cases from superficial vessels, from sinuses, etc.) can be stopped by pressure. Ligating the vessel when possible is preferable, but sometimes it is not possible. (6) The last point I wish to speak of is a somewhat doubtful one in my mind, and I only desire to call your attention, to it. This is the length of time during which packing should be left in the intracranial cavity. I am inclined to think that the present tendency is to remove it too early. Gentlemen : I thank you for your attention, and I hope that you will pardon my presumption in speaking on surgical subjects before a surgical society. -•-
doi:10.1056/nejm189501241320402 fatcat:jx7tx6tnyvbedfvnm7kud5bceq