Antall József szerk.: Orvostörténeti közlemények 109-112. (Budapest, 1985)

A TERMÉSZETTUDOMÁNYOK ÉS A MEDICINA A RENESZÁNSZ ÉS A REFORMÁCIÓ KORÁBAN - Bakay Lajos: Bakócz Pál agysérülése Itáliában

5. Paré, A

. : Oeuvres complètes d Ambroise Paré révues et collectionnées sur toutes les éditions avec les variantes par J. F. Malgaigne. Baillière, Paris 1840. 6. Pott, P.: The chirurgical works ofPercivall Pott, F. R. S. Johnson, London 1808. 7. Putti, V.: Berengario da Carpi. Capelli, Bologna 1937. SUMMARY The first detailed description of a surgically treated injury of the brain substance is given by Berengario da Carpi in his book ,,De fractura Calve," published in 1518. The patient was Sir Paulus, a cleric, nephew of Cardinal Tamas Bakocz, who accompanied his uncle on his trip to the papal conclave in 1513. He was hit on the head with a halberd and treated in Bologna by Berengario, one of the foremost surgeons of his time. The wound was deep, it penetrated the lateral ventricle resulting in loss of brain substance and cerebrospinal fluid fistula. Berengario removed broken skull fragments embedded in the brain and left the wound open. For 50 days following the initial operation cerebral tissue and liquor issued forth. The free flow of ventricular fluid may have prevented infection because the surgeon drained the wound with a cannula. When he thought that the wound was dry enough, he attempted closure. A few days later the expected complication developed in form of brain abscess and meningitis. The patient developed high fever, a major epileptic seizure and lapsed into coma. Berengario opened the wound again. A great amount of milk-colored, watery material was evacuated, whereupon the seizures stopped immediately and the patient regained consciousness. Berengario replaced the cannula, re-established drainage and irrigated the wound until it eventually closed spontaneously. Pal Bakocz was restored to health. ,,He lived a long life," writes Berengario, ,,and achieved high rank in the church." L. BAKAY, M. D. Professor of Neurosurgery 152 Bryant St., Buffalo, N. Y 14222, U. S. A.