THE HEAD. 3 



THE HEAD. 



3. Scalp : its density. The great toughness of the 

 scalp, more especially at the back of the head, is owing to its 

 intimate connection with the cranial aponeurosis, the scalp 

 vessels and hair bulbs intervening. This density often ob- 

 scures the diagnosis of tumours on the cranium. A tumour 

 growing upon the head may be either above or below the 

 aponeurosis of the scalp. If below, it will have a firm resisting 

 feel, being bound down by the aponeurosis. Nevertheless 

 its firmness and resistance may depend not simply on its 

 confinement beneath the aponeurosis, but on its having its 

 origin within the skull. Look with suspicion, then, on every 

 tumour on the head that will not readily permit you to move 

 it about, so as to be sure of its connections prior to an attempt 

 at extirpation. 



The scalp moves freely over the pericranium, to which it 

 is very loosely connected by areolar tissue. When suppu- 

 ration takes place in this tissue free incisions through the 

 dense scalp must be made to let the pus out. 



4. Arteries of scalp. The supra-orbital artery can be 

 felt beating just above the supra-orbital notch, and traced for 

 some way up the forehead ; the temporal (anterior branch) 

 ascends tortuously about one inch and a quarter behind the 

 external angular process of the frontal bone ; the occipital 

 can be felt near the middle of a line drawn from the occipital 

 protuberance to the mastoid process ; the posterior auricular, 

 near the apex of the mastoid process. All these arteries can 

 be effectually compressed against the subjacent bone. 



5. Skull-cap. The skull-cap is rarely quite symmetrical. 

 This want of symmetry is often obvious. It may occur in 

 men highly gifted, as in the celebrated French anatomist 

 Bichat. As to shape and relative dimensions, no two heads 

 are exactly alike, any more than are two faces. It is beside 

 my present purpose to go into the question of craniology 

 more than to say that, although the cranium does not exactly 

 follow the brain in all its eminences and depressions so as 

 to be like a cast of its surface, yet it certainly indicates the 



