J. Ganz, PhD
Royal College of Surgeons of England, Ulverston, UK
The works of Hippocrates, Celsus and Galen are taken as information sources for a proposed approach to the treatment of traumatic brain injury. All three authors point to changes in the level of consciousness in cases of traumatic brain injury. According to modern concepts, the classification of fractures proposed by Hippocrates is somewhat unusual. He spoke of hedra and bruises and noted that the latter may not be identified under examination. This view has nowadays been rejected. Discussing damage that he called a depressed fracture, Hippocrates describes an extensive comminuted fracture in which the bone fragments can be moved in or out. He advised not to touch these fragments. Celsus described in detail the manipulations that needed to be carried out on depressed fractures, a technique that is comparable to modern techniques. He did not mention extensive comminuted fractures and did not give a classification of fractures. Galen described new tools and new methods. He perfected the technique of craniotomy, promoted the use of cycliscus and a special tool with a blunt tip – the lentiform knife, which protected the dura from damage when removing bone fragments. His method of treating extensive depressed fractures seems too radical these days. Hippocrates, Celsus and Galen made a significant contribution to the development of treatment methods for traumatic brain injury and the development of medical practice. The unusually high level of treatment performed by these scientists without any proven scientific basis and proven medical research techniques is striking.
Keywords: Hippocrates, Celsus, Galen, skull fracture, depressed fracture, soul, brain function