Journal : Photographic review of medicine & surgery ; vol. 1., no. 1.
Philadelphia : J. B. Lippincott & Co., 1870-71.
Description : pp. 2-3, [1] pl. ; ill.: 1 photo. ; 24 cm.
Photograph : mounted albumen.
Subject : Meningocele.
Notes :
THE little patient represented in the above photograph is now eight months old, is a male child, and in the enjoyment of very good health, save the congenital deficiency in the bones contributing to the formation of the posterior fontanella. The development in every other respect is not in any way inferior to other infants of the same age. The mother states that her babe nurses well, is at times bright and lively, but has attacks of crying, which continue sometimes almost the entire night. The enlargement is soft, covered with a light growth of hair, and not unlike other portions of the scalp. When pressed it does not appear to produce any pain, but when moved from side to side it always provokes some fretfulness. It seems to consist of the ordinary integuments of the scalp, and the membranes of the brain distended with the subarachnoid fluid. It is pedunculated in form, and measures ten and a quarter inches in its greatest circumference, and eight and three-eighths inches in its greatest longitudinal diameter.
Fifteen days after birth I placed an elastic ring of rubber around its base, so as to make gentle but persistent pressure, and, after about two 'weeks, replaced this with a still smaller ring, and so diminished the size from time to time, until, finally, one portion of the base became sore, rendering it necessary to suspend treatment for a time. The parts having healed, I resumed the compression of the pedicle by applying a ribbon of lead, tightening it a little every week. The pedicle has been reduced in circumference by this method almost one- half. It is hoped, by continuing the constriction, aided by the development of the cranial bones, it may be reduced to a mere cord and admit of removal.