Note 784 — ON INJURIES OF THE HEAD.

Vidus Vidius thus explains the hedra or sedes: “Inciditur os ita ut teli vestigium remaneat, quod genus fracturæ appellatur a Hippocrate ἒδρα, id est sedes, quum (ut ipse inquit) appareat in osse qua telum insederit; fit autem ab acuto telo, quod et ipse in sequentibus, et Galenus, in Commentario, in librum memoriæ prodidit, quum sub telo acuto incidi os dixit. Requirit autem sedes ut incisum os nullo modo ad cerebri membranam inclinatur.” (Chirurg. Græc., p. 71.) Andreas à Cruce defines it thus: “Potissimum vero sedes vocatur ubi osse in suo statu remanente qua parte telum insederit apparet.” (De Vulneribus, 1. 2.) By hedra would appear to have been understood a dint, or impression, left in a bone by a blow which has not produced fracture or depression. It was also applied to a cut or slash affecting only the outer plate of the skull. Hippocrates, it will be remarked, pronounces this sort of injury not to be dangerous of itself, but M. Littré relates a case taken from the “Journal de Médecine,” in which a sabre-cut, which only penetrated through the external plate of the cranium, and did not touch the internal, proved fatal. (Op. Hippocrat. iii., p. 170.) Our author, in the latter part of this paragraph, mentions cursorily injury of the skull at a suture, and more circumstantially in the twelfth paragraph. This accident is very correctly described by the later writers, under the name of diastasis. See Heliodorus (ap. Chirurg. Veteres, p. 100), and Archigenes (ibid., p. 117). Pott declares that he did not remember having ever seen a single instance of recovery when there was separation of the bones at a suture. Morgagni, in like manner, represents the case as being of a particularly serious character. (De Caus. et Sed. Morb.) I once saw a strongly marked case in which there was a considerable separation of the bones at the upper part of the temporal suture, along with an extensive wound, unguardedly inflicted by the scalpel of a juvenile surgeon, in order to explore the nature of the accident. As might have been expected, under these circumstances, the case had a fatal issue. Mr. Guthrie writes thus of diastasis: “It is well known, that when a violent shock has been received on the head, particularly by a fall on the vertex, the sutures are often separated to a considerable extent; these cases usually terminate fatally.” (p. 135.)