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Fourteen cases of compound fracture of the skull

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MackenzieJE_1910redux.pdf (7.869Mb)
Date
1910
Author
Mackenzie, John Eddie
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Abstract
 
 
The first, thirteen cases were treated in the Hospital attached to the w esselton Fine Compound. The fourteenth case was treated in the General Hospital Kimberley and was the result of an assault. The first five cases resulted from blasting accidents or from the falling of lumps of blue-ground from the roofs of chambers in the underground workings in Wesselton Diamond Mine. The next seven cases resulted from injuries received during a prolonged tribal fight between the Transvaal Basutos and the British Basutos in the Wesselton Mine Compound. There »-ere 1,2,00 combatants on one side and 800 on the other. There were 59 causalities, including several cases of compound fracture of the skull, compound fractures of the leg, scalp wounds, and lacerations arid bruises of various parts of the body. The six cases (Nos. 6 - 11) were operated upon on the 2 6 t h December, 1909. T’he first, case was placed on the table to be shaved and scrubbed at 9.15 a.m., and case eleven was dressed and removed from the operating table at 12 noon; the six operations having taken exactly 2 hours and 45 minutes. Case 12 was injured in the same fight, but was not found till Monday evening, the 27th. He was operated on next day, the 28th December, 1909. Cases 13 and 14 are mentioned on account of their interest in connection with the question of diagnosing whether an injury and fracture of the vault of the skull includes its whole thickness and the consequent decision as to whether trephining is advisable in all cases of compound fracture of the skull. The first 12 cases were operated on iri the theatre of the Wesselton Mine Compound Hospital, Hr S. Wicks was the Anaesthetist and used Chloroform. The assistants were two white male dispensers, and three black ward boys. After operation the patients were removed to the surgical ward on a stretcher and put to bed and watched till recovery from the anaesthetic was complete. In all the Oases the heads were shaved after bleeding had been stopped by pressure with forceps or ligature, and the skin was well brushed with warm solution or mercurial solution 1.2.000., then the head was washed down with sterilized Horic lotion which was also used during the operations. The swabs were of cotton wool prepared with every antiseptic precaution. All the instruments used were sterilized before use / use and placed in sterlie Poric Lotion. Each assistant had his duties definitely allotted and used all antiseptic precautions. The head was placed on a mackintosh covered with a towel wrung out of mercurial solution 1.2000. The native ward boys held the patient and brought the lotions and held dressing trays and receivers. In each Case Silk-worm gut threaded in a fully curved needle was used to stitch lip the skin wound. The first, dressing was of Cyanide gauze next the wound and cotton wool outside, both from sterile covered dishes. The bandage was applied as necessary. These 12 Cases were all adult native males. The exact age of a native is very difficult to obtain; they have no idea of time as we count it. The youngest, "Jack Modifan" was about 24 and the rest were older, one "April" being about 45 years of age.
 
URI
http://hdl.handle.net/1842/35055
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  • Edinburgh Medical School thesis and dissertation collection

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