48 Injuries of Bone. 



3. 22. Comminuted Fracture ofthe Skull.— Fractured portions 



of a cranium, removed at St George's Hospital. 



The patient died. B. C. 1. 2. M. 11. 



3. 23. Trephining" for Fracture and Meningeal Haemor- 

 rhag'e. — Portions cut out by the trephine from the skull of a 

 boy 14 years old, by Mr Wilson. 



"He had been thrown from a horse about two hours before I saw 

 him. He was taken home insensible, and remained so until the operation. 

 Finding the bone fractured, and a veiy copious hajmorrhage flowing from 

 the fractured part, I immediately applied the trephine, and having thus 

 made an opening and scooped out the coagulated blood, I found that the 

 bleeding came from the principal artery of the dura mater, nearer the 

 basis of the skull than could be got at without destroying life. I was 

 obliged to apply the crown of the trephine seven times before I could 

 remove all that pressed upon the brain. An hour after the operation the 

 boy rallied and recovered without experiencing a single bad symptom 

 in the cure. The operation was performed in 1792. In 1807 I saw him 

 quite well, but the whole ofthe bone had not regenerated." 



The under surface of the pieces removed by the trephine 

 show impressions of the middle meningeal artery. As several of 

 the circles are broken, the fracture must have traversed this region. 



B. C. 1. 2. M. 13. 



3. 24. Hairs driven into Fracture of the Skull.— Portion 



of bone removed by a trephine in a case of compound depressed 

 fracture of the skull. 



In the fissure on the outer surface of the fragment hairs are 

 embedded, and it should be noted that this fissure is on the 

 outer side only. From the case of Jane Porter, Ward 18, Eoyal 

 Infirmary, Edinburgh. G. C. 3303. 



Presented by A. G, Milleu, 1891. 



3. 25. Compound depressed Fracture of the SkuU.- 



. Portions of the frontal bone removed in a case of fracture. 



