The diagnosis, prognosis and treatment... of cranial injury after head trauma are in an unsettled state.... The more modern devices of treatment, such as the use of intravenous hypertonic solutions, repeated lumbar puncture, and even subtemporal decompression of the brain are all methods not as yet proved to be either essential or even valuable in the treatment of this condition.
These words are quoted from an editorial in the New England Journal of Medicine for April 1933.1
In the same year Dandy2 stated that 20 per cent of the total number of patients with severe head injury must be regarded as beyond redemption by any rational means available and that another 10 per cent can be saved only by a subtemporal decompression.
Coleman,3 in a recent contribution on the management of acute head injuries, said:
In my own experience with dehydration it was found that if the