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April 1, 1893

REPORT OF CASES OF TREPHINING AND CEREBRAL INJURY.From the records of the Cambridge Society for Medical Improvement.

JAMA. 1893;XX(13):354-356. doi:10.1001/jama.1893.02420400006003

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Case 1.  —Reported by C. E. Vaughan, M.D. Wm. R. S. B., age 24 years. December 13 was thrown from his horse, striking his head. For twenty minutes appeared unhurt, then a slight convulsion occurred followed by four more in the course of an hour. When he reached the hospital the pupils were somewhat contracted, but equal and responsive to light; the skin was cool and dry, and the face pale; pulse 42, temp. 99°, and the respiration 16. There was no complaint of pain, but a strong desire to urinate and to defecate, and a large amount of apparently normal urine was passed voluntarily. There was no evidence of paralysis, or external signs of fracture or depression of the bone, or injury. Biliary vomiting occurred, and soon intense diffuse headache, with pain in the dorsal region. Bowels reacted with great difficulty. The patient was conscious, yet the mind was

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