- i a 
: = 
_ BOTANIC PHYSICIAN. 
_ “These granulations, however, instead of merely filling up the’ 
- eancy, in some cases push out beyond the surface so as to form pen 
dulous tumors. But in general, these tumors begin to diminis 
soon as the soft granulations in the perforations of the skull begin to 
acquire a firmer consistence ; and when the ossifying process is cot 
ted, they are in a manner cut off, and fall of their own accord. 
Compression of the brain from extravasation.—By whatever cause 
the brain may be compressed, the symptoms that ensue are nearly 
the same. I shall only observe therefore, that all the symptoms aris 
- dmg from a compressed state of the brain, are produced with ane 
certainty, and attended with as much hazard, from effusions of blood; 
serum, or pus, as from the most extensive depressions of the bone; 
and in general are more to be dreaded ; for;where the bone is broke 
‘Or depressed, the point of injury is easily known; whereas in mere 
_ extravasation the seat of the collection cannot be known with 
‘0 compression of the hrain from extravasation, We have the same 
in view, with that which a depressed portion of the skull ren- 
S necessary ; having endeavored to ascertain the seat of the imjut 
Weare to make one or more perforations, in order to discharge the € 
- travasat d fluid.. The chance of benefit from an operation in this ¢ 
__-will not, indeed, be great; but as it is the only chance of saving li 
_. im severe cases, we are certainly justifiable in the attempt. 
__ After the skull is perforated the effusion may be found to be below 
= the dura mater, or even within the second membrane, and in con 
: with the brain. This may be known by its being of a dark @ 
color, very tense, and elastic. This collection, when found, 
_ certainly to be discharged, as unless this is done, the intention 
. not fulfilled, although the chance of success is 
fest mode of opening the dura mater, is tos 
7 
= 
gee 
small hole by 
angerous. Fissures commonly heal wi 
taking place ; but they may prove da 
bloc exciting infl 
