3G: J 
fome days after, produce ftupor or infenfibility. TraQures with 
confiderable depreflion, extravafations, &c. fhew no alarming 
figns for many days ; but ftupor rmmediately following a fail or 
hurt is an uneguivocal fign of concuffion, and of concuffion only. 
Not but that I have met with three cafes, and each of them 
‘mortal, where the fymptoms of concuflion immediately ap- 
peared, though in each the fraCture and depreffion were evident. 
But this only proves that in cach the injury was fo great that 
the yielding of the fkull was not fufficient to deftroy the force 
of motion. 
Ix cafes of death, after injuries of the head, where concuiffion 
was the caufe, I have invariably obferved the following appear- 
ances :—the pericranium and fkull were uninjured ; the dura 
mater adhered to the latter; there was rarely any extravafation 
of blood, and this but flight, and out of the reach of any in- 
ftrument. In a word, I could get no information, except that 
in thofe who died foon after the accident I have fometimes 
thought the brain did nor completely fill the cavity of the 
cranium. To this let me add, that inftances can be adduced 
where leaps or falls from an, high place, on hard ground, 
where the head has been far removed from the feat of the in- 
jury, have produced all the fymptoms of concuffions. 1 well 
know that many have been trepanned, and great cures boafted 
in thefe diforders; but fure I am, that whatever merit, they” 
might juftly claim, by endangering nature’s endeavours and pro- 
tra€ting recovery, they had none with refpect to the merit of 
the cafe. 
I pIvipe 
