Complete Record - Heirs of Hippocrates No. 928.5

PERCIVALL POTT (1714-1788) Observations on the nature and consequences of wounds and contusions of the head : fractures of the skull, concussions of the brain, &c. Printed for C. Hitch and L. Hawes 1760 1st xxxii, 182 pages 24 cm

For more information on this author or work, see number: 928

First edition of a landmark in the history of neurological surgery. It was Pott’s emphasis, in this book, on the importance of surgical management of trauma to the skull and brain that prepared the way for subsequent attempts by surgeons to treat these kinds of injury. Pott was not the first to insist on the importance of trephining for head wounds. But his reputation as the leading British surgeon of the period lent authority to his stress on the value of operating to release infective (or “purulent”) matter at the site of an abscess and possibly also to facilitate removal of blood. In this book, Pott described “the signs by which extradural hematoma can be differentiated from abscess. Characteristic of the latter is the ‘puffy tumor’…, a circumscribed swelling of the scalp over the involved area. He also recognized the lucid interval which precedes the coma of extradural hemorrhage, and adds that the initial compression causes a loss of consciousness which may merge into that of cerebral compression without the period of lucidity. The far graver significance of subdural or intracranial hemorrhage was known to him, as was also the impossibility of positively differentiating between them and those of the extradural variety. He was partial to the use of the trephine and employed it much as modern neurosurgeons do their exploratory burr-holes when the presence of a fluid accumulation cannot be ruled out... The description of the clinical manifestations of the various injuries is excellent” (Zimmerman and Vieth, Great ideas in the history of surgery, 327). This book contains a description of the eponymously named “Pott’s puffy tumor,” “associated with osteolyelitis of the skull” (Kelly, Encyclopedia of medical sources, 331).

See Related Record(s): 928 929 930 931

Cited references: Garrrison & Morton 4850.5; NLM 18th cent., p. 361; Waller 7598; Wellcome IV (pg. 423)

John Martin M.D. Endowment