ie > ae | 
with himfelf. But I faw and dreaded the confequences. I told 
the people that thefe alarming fymptoms proceeded not from 
cold, but the conftant and uniform preflure on the brain; and 
that if any chance remained for his recovery, which | much 
doubted, it muft be by a fpeedy removal of the caufe ; and if they 
confented I would not fhrink from this difagreeable bufinefs, I 
dire@tly made the fecond perforation, and foon raifed the part; 
but, alas! the mifchief had been already completed. That day 
and the next he feemed a good deal lighter; but, about ten 
at night of the fecond day, his neck was obférved to be co- 
vered by a bloody ichor iffuing from the fore. Next morning 
his pulfe was more languid, and the dura mater quite black. 
Towards night the bloody ichor increafed ; he became flightly 
convulfed with ftupor. About ten the fubftance of the brain 
poured forth, and he expired next morning. 
FRAcTURES with a depreffed bone always require the opera~ 
tion; and though fome cafes may be adduced where an happy 
recovery has fucceeded without this adoption, yet it muft arife 
from particular circumftances by no means to be depended 
on. For inftance, the depreflion may be uniform, fo as no 
point of the fracture may prefs on the brain. In fuch an in- 
{tance no doubt things may come about without trepanning; 
but have we any fymptom to determine this point? None that 
I know of. Numbers I have feen perifh by neglecting the 
operation, becaufe they found themfelves free from pain and 
fever at the beginning. As then trepanning is a fafe opera- 
tion in any tolerable hands, no confideration fhould make the 
furgeon decline or procraftinate it. He has already feen the 
Vou. IV. Y happy 
