[ °%3s 2] 
there was a fracture. I removed the integuments, and found 
the bone fractured near two inches in length, but {till the 
parts were nearly upon an equality, and the bone firm to the 
touch. As he bled a good deal’ I did not direc venefection, 
but ordered fome powders of nitre and jallap, and. the faline 
mixture. His head-ach was-not abated next morning, fo I 
direéted a large blifter to ‘his back, which I defired fhould re- 
main on for twenty-four, hours, This removed the head-ach, 
and the wound went on well. In five days after, he com- 
plained of violent fhiverings, and ‘I fhould have concluded them 
“to be the precurfors of matter forming ‘on the brain, had’ 1, 
“in the courfe of many hundred fractured fkulls, feen a fimi- 
lar inftance; but I had not. He was not trepanned: the bark, 
in fome time, removed thefe complaints, and he is again 
- abroad. 
Havinc thus, I apprehend, clearly proved, that many frac- 
tured {kulls do not demand the trepan, it remains that I fhould 
clearly difcriminate between thofe and other feemingly flight 
fractures, which abfolutely require it. In the courfe of my 
practice I have conftantly obferved, that fractures of the cra- 
nium are more extended in the inner than the outward table, 
and of courfe, that fimple fractures, fuch as I have deferibed, 
may do confiderable damage within, whilft all is fair with- 
out. Fractured fkulls in general (with a very few exceptions) 
. are attended with no very alarming fymptoms for many days. 
They are free from fever and inflammation; nor is reafon in 
the fmalleft degree impaired. But in the courfe of ten, twelve, 
x 2 or 
