CEREBRAL ABSCESS FOLLOWING INJURY OF 
THE SKULL. 
BY THOS. W. KAY, M. D., 
SCRANTOH, PA. 
Formerly Surgeon to the Johanniter Hospital, at Boyrout, Syria. 
Murscha, set. 28, a black male, presented himself 
at the Johanniter Hospital on the 14th of May, 1888, 
with the following history : 
Two years previous, while engaged in a quarrel near 
Jaffa, he was struck on the head with a heavy staff and 
left for dead. He regained consciousness after several 
hours, and from that time to the present has had no 
sickness of any kind, nor has he had paralysis or pain 
in the head. 
He was in excellent health when he presented him- 
self, being in full possession of all his mental faculties, 
and complained only of an offensive discharge from 
the head, which had been of six month's duration. 
Examination revealed three sinuses over the right 
parietal eminence, and necrosed bone was found at 
the bottom of all of these ; so I connected two of them 
by an incision and removed, by sequestrium forceps, a 
piece of bone 2J inches long by inches broad, con- 
sisting of both tables of the parietal boue. As soon 
as this was done between and 2 ounces of very 
offensive brain substance, which had not entirely 
Reprinted from The Journal February 16th 1889. 2 
changed into pus, escaped. After carefully washing 
out the cavity, it was dressed antiseptically, and this 
was renewed every day. 
Two days later, several smaller pieces of the inter- 
nal table were removed, and the cavity left, after the 
escape of the diseased brain substance was earefully 
measured. It was found to be elliptical in shape, 
being inches long by If inches broad, and 1 inch 
in depth. The direction of its long axis was repre- 
sented by a line drawn from the post. inf. angle of the 
right parietal bone to the middle of its superior 
border, and its deepest point was just below the pari- 
etal eminence. 
In a few days healthy granulations had sprung up, 
and by June 7 the cavity was so nearly filled that the 
man was allowed to leave the hospital. 
It is interesting to note the length of time that 
elapsed between the receipt of the injury and the ap- 
pearance of the discharge ; and also the entire absence 
of any paralytic or cerebral symptoms after such a 
large loss of brain substance.