At least it got rid of the tapeworm…

head injuryOn the 14th of May, 1867, Dr Jewett of Summit County, Ohio, was called to see Joel Lenn, 27, a French coal miner, who had suffered a serious injury.

While blasting coal in the works of Messrs. Cross & Payne, near this village, the blasting barrel (a 5/8 inch gas pipe four feet in length) struck him near the external angle of the superciliary ridge of the right side, fracturing the bone, broke down the supra orbital plate, protruding the eye considerably, passed through the right anterior lobe of the brain, lacerating the longitudinal sinus, passed through the left middle lobe, and emerged from the head at a point about an inch and a half above and behind the left ear.

The rod had passed right through his skull and remained lodged inside it.  His colleagues removed it with considerable difficulty, because it had bent on impact.

For several days he lay in an almost perfect state of coma, with little or no hope of recovery.  Cold was applied to the head, the bowels were with difficulty opened, requiring large doses of podophyllum and calomel, and which, with abstinence, had the effect to dislodge an old boarder, in the shape of a tape worm seventeen feet long, for which he had been previously unsuccessfully treated.

So there was a bright side, although I doubt M. Lenn appreciated it at the time.

The wound was kept open by frequent deep probings, and the head kept in a position, as far as possible, to favor drainage.  Fragments of skull, coagulated blood, and broken-up brain tissues were freely discharged, which gradually relieved the pressure, and, of course, the coma.

Almost a fortnight after the injury he began to regain consciousness, was able to eat and on occasions seemed to understand what was being said to him.  His improvement was slow, but eight weeks after the accident he was able to leave his bed, without any sign of paralysis.

Physically, he now seems as well as ever.  He seems to be perfectly rational, and will reply correctly in monosyllables to questions, but is entirely unable to connect words.  He succeeds best, when excited, in swearing in French.  This difficulty shows that that portion of the brain controlling speech was seriously and probably irreparably injured.  Up to this date, January 24, 1868, over eight months from the injury, he shows no improvement in this particular. The amount of mental power is also much impaired.

It’s a miracle that this patient survived: apart from the devastating cerebral trauma, the risk of infection was overwhelming.  Modern brain surgery got underway in the next two decades with the work of pioneers such as Sir William Macewen and Sir Rickman Godlee, but many of their early patients succumbed to meningitis, even when operations took place in aseptic conditions.

[Source: Boston Medical and Surgical Journal, 1868]

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