MEDICAL STUDIES 31 



with the "Charter" occurred at this time, and many 

 people were hurt. It was curious to observe the 

 apparent cleanness of the cuts that were made 

 through the scalp by the blow of a policeman's 

 round truncheon. 



It sometimes happened that a severe case was 

 brought at night-time, which required higher surgical 

 skill than could properly be expected in the house 

 surgeon, who, though professionally qualified, was 

 young, and therefore relatively unpractised. If the 

 treatment of any such accident admitted of no delay, 

 a messenger was dispatched to the house of the 

 surgeon himself, to wake and bring him. One of 

 these events made a great impression on me. It 

 was that of a man, a small piece of whose skull had 

 been depressed by something falling on his head and 

 stunning him. He was brought in utterly unconscious, 

 with the " stertorous " or snoring respiration character- 

 istic of such cases. The man had to be trepanned, so 

 the surgeon was sent for. In the meantime everything 

 was prepared for his arrival. The trepan is a hollow 

 steel cylinder with teeth cut out of its lower rim, used 

 to saw a circular wad out of the sound bone nearest to 

 the fracture. A miniature steel crowbar is used to 

 raise the depressed fragment, and a rod to lay across 

 the sound bone as a fulcrum for the crowbar. I seem 

 to see it all before me as I write. The brightly lighted 

 room, the apparatus in order, the surgeon at work, the 

 eager faces of the bystanders, and the utterly uncon- 

 scious patient. The wad was cut out, the crowbar 

 adjusted, and still the monotonous snore continued 

 unchanged. Then pressure was put on the free end 

 of the crowbar, the broken bit of skull was raised, 



