The workes of that famous chirurgion Ambrose Parey translated out of Latine and compared with the French. by Th: Johnson

CHAP. II. Of the causes and signes of a broken Scull.

THe causes of a broken Scull are externall, as a fall, a blow or stroake with any kind of weapon, sharpe, obtuse, heavy, hard, the bitings of * 1.1 Beasts, and many other things of the like kind. But the signes by which we come to know that the Scull is broken, are of two kinds; for some of them are found out by the reasoning and discourse of the mind, o∣ther by the sense, as those which lay open the wound to the eye and hand.

The Rationall signes shew by these things which have happened upon the thing it * 1.2 selfe, whether it be, and of what sort it is. For you may know the Scull is broken, if the patient shall fall down with the stroake, or if he shall fall headlong from a high place upon some hard thing. If for some time after the stroake, he shal lie without speaking, sight, and hearing, if he shall have felt and feele much paine, so that he is often forced to put his hand to the wound. But also the weapon is to be considered, that is, whether it be heavy, obtuse, pricking or sharpe. Also we must consider with what & how great strength the stroake was given, and with how great anger and from what distance the weapon fell. Also he must consider whether the patient receaved the blow with his head unarmed and naked; whether he fell into a sowne presently after the blow; whe∣ther when he came to himselfe, he was in his right senses; whether his eies were blin∣ded, whether he was troubled with a giddines or dizines, and whether he bled at the nose, mouth, eares, or eyes, and lastly whether he vomited. For Hippocrates writes, that * 1.3 those who have their braine cut, must necessarily have a feaver and vomiting of cho∣ler to ensue thereupon, which Galen confirming in his Commentary saith, that the same happens also when the wound comes to the Membranes of the braine.

Also a dull sound as from a broken vessell comming from the skull, (the hairy sealpe and Pericranium being taken off) and it being lightly smitten upon with an Iron probe, is sayd to be a signe of a fracture thereof, as it is recorded by Paulns * 1.4 Aegineta. Truely all these signes make a great conjecture or rather assurednesse that the skull is wounded, and the braine hurt, as which cannot happen unlesse the bone be broken, as Celsus hath written. Yet many have had their sculles broken, who had no such signe immediatly after the blow; but this is very seldome. But I doe not thinke fit amongst so many signes, here to omit that which is set downe by Guido. If any (faith he) will know in what place the scull is broke, let the patient hold fast betweene his foreteenth, one end of a lute string or thread, and the Chirurgion hold the other in his hand; then let him lightly touch or play upon the string with his fin∣gers; for in the very instant of the sound or stroke, the patient will bee certainely ad∣monished, or perfectly perceive the part of the scull that is broken, and as orecome and forest by this sence of paine, will by lifting up his hand make demonstration thereof. As yet I have not beeneable to finde the truth hereof by experience, al∣though I have made triall of it in many. Wherefore I cannot say any thing certaine∣ly of this signe, as neither of that which is mentioned by Hippocrates in Coais Pras. * 1.5 In such as you doubt, whether the bones of the scull be broken, or not, you must judge by giving them the stalke of Asphodill, to chaw on both sides of their jawes, but so that you bid them withall observe, whether they perceive any bone to crackle, or make a noyse in their heades, for these which are broken seeme to make a noyse.

But passing over these things, now let us come to these signes, which may be ob∣vious to our senses.

Notes

• * 1.1

  The externall causes.
• * 1.2

  Rationall cau∣ses.
• * 1.3

  Aphor. 50. sec. 6.
• * 1.4

  Lib. 8, cap. 4.
• * 1.5

  Hippocrates and Guidoes conjecturall fignes of a broken scull.