A Ramrod in the Brain.—Recovery.

Waikato Times, Volume XXIV, Issue 1991, 11 April 1885, Page 2 (Supplement)

A Ramrod in the Brain.—Recovery.

B\ Gco. Fischer {Deuttche Zeihchuft f. Chiruryie) tho following unparalleled case in surgical literature is related : — At a shooting festival in Hanover, it occurred that a carbine was unexpectedly discharged, from which the ramrod had not been drawn. The ramrod struck a man in the back, was driven through the neck and head, from which it projected. The man reeled, staggered, but did not fall. He was laid down ; he remained motionless and speechless. A comrade tried to draw the rod out ; he used enough force to raise the body from the ground, but without success. Other attempts were made to that end, so much bo as to drag the body over the ground, but failed. He had nausea and vomiting, but finally answered questions rationally. Four hours later he was in the hospital. The obtuse end of an iron rod, thirty centra, long, projected on the left side, over the foreman supraorbitale. The integuments grasped tightly tho rod ; not a drop of blood escaped. On the right side of the neck, below the angle of right submazilla, was a great hard and painful swelling. Nothing abnormal could be felt in the throat. Between the right scapula and the vertebral column in ihe region of the fourth dorsal vertebra was a gunshot wound of the size of a five cent piece, with black edges ; the patient could stand up, was weak, apathetic, but could give rational answers, and remembered distinctly the whole occurrence. The pupils were dilated, sight not very good, bleeding from right nostril, breathing normal, pulse rhythmic, sixty. The ramrods of carbines have a large button on one end ; and as these rods are very short, the button end must necessarily be embedded in the neck. VVithcut an anresthetio, the wound was enlarged, and the button end of the rod was discovered up in the region of the sterno cleido-mastoideus. The larger vessels were not seen. The rod was firmly wedged in the cranium, so that in order to loosen it the bones had to be chiseled away around it, and by many blows of a hammer it had to be driven downward before it could be extracted. No bleeding. The patient was perfeotly cognizant of what was going on, and made many sensible observations. He lay absolutely motionless, while, with a hammer, the rod was driven down. The operation lasted one hour. The rod was fifty centra, long, tho lower end six mm., the upper seven mm. thick. The button had a circumference of four centra. Cerebral symptoms were only trivial, first those of conousßion, late of compression of tho brain, memory little impaired. Esoape of cerebro-spinal fluid in the right nostril. Atnaurosis of right eye, suppuration of right ea& temperature a little higher, frequency of pulse, slow respiration, digestion, micturition not disturbed. The length of gun shot canal was thirty-five centm. In order to ascertain the probable injury of the various organs and tissues, Prof. Henle of Gottingen imitated tho canal on a cadaver. He found : The ramrod after penetrating the back between the M. spleniua cervicia and M. levator scapulie without injuring the cavity of the chest, before the vena jugulans int. and art. carotis communis, near the bifurcation, behind tho M. sterno-cleido mastoid, behind the belly of tho M. stylo hyoid, and stylo-glossus ; immediately behind the posterior margin of the median root of the pterygoid processes the ramrod entered the cranial cavity. It penetrated to the right sphenoid fossa, the lower floor of the orbital cavity, went through the right canalis optious, lacerated the optic nerve. Here it struck the right gyrus, went then a distance between both hemispheres to tho left side of tho falx cerebri, then through both gyri fornicati up, three cm. long through the left gyrus frontalis superior, and through the os frontalis ant. After nine weeks, patient left tho hospital cured, after eleven months was perfectly well, attended to hia very laborious duties, and dances all night as often as he can ; amaurosis oontinues. — St. Louis Med. and Surg, Journal.