MUNIZ—MC GEE] OPERATION ON DEPRESSED FRACTURE 41 
severed on the lower side, around the median end, and part of the way 
around the upper margin; this tongue of bone is itself indented and 
warped, evidently by the force of the blow producing the fracture; and 
two fissures partially crossing its base nearly separate it from the unin- 
jured bone. The rupturing of the inner table was quite as complete as 
that of the outer; the inner table was split and torn apart beneath the 
depressed tongue, and a sliver 15 mm. long and 10 mm. wide remains 
attached at the lower anterior side of the wound. Apparently a nar- 
row zone of the outer table has disappeared from this portion of the 
wound, since the depressed tongue is 1 or 2 mm. narrower than the 
aperture; and the antero-superior extremity of the tongue has also dis- 
appeared, leaving a clear aperture of about 5 by 10 mm. In general 
the wound is more extensive on the inner surface of the cranium than 
on the outer, fer, as is usual in case of depressed fracture, the margins 
are undercut, the tables separating somewhat on the diploe. The 
features of this wound are slightly masked by the marks produced in 
the unfinished operation. 
The indubitable features of the operation are three principal inci- 
sions, with a number of minor scratches. The inost. prominent incision 
is nearly horizontal, traversing the upper part of the wound; it is 30 
mm. in length and penetrates both tables of the bone for a length of 
10 mm. immediately above the wound. Its anterior extremity divides 
into two strong and several feeble scratches, each evidently made by a 
single moderately sharp point; the deeper portions are V-shape in sece- 
tion, and the wall of the incision above the wound shows parallel stri- 
ation, as if ground by arough surface; in short, the incision is precisely 
such as would be produced by a rather sharp stone knife or spear- 
head, worked reciprocally with considerable pressure, and the asso- 
ciated scratches are such as would almost inevitably be produced by 
the slipping of such an instrument in the hands of a clumsy operator 
at the beginning of the operation. The second incision starts from 
the anterior extremity of the first, at an angle of about 60 degrees, 
and skirts the lower margin of the fracture for half its length, i. e., for 
about 19mm. It is a minature homologue of the incisions displayed in 
cranium 1 and other specimens, V-shape in section, deepest and broad- 
est toward the middle, narrowing and shallowing to mere scratches at 
the extremities; in this case, too, there are a few scratches, evidently due 
to the slipping of the instrument. Tor a length of 5 or 6 mm. it enters 
the diploe; it does not penetrate the inner table. The third incision 
crosses the first near its posterior extremity, at an angle of about 60 
degrees, the three being so placed as to describe an equilateral triangle 
coinciding with the anterior third of the fracture. This incision is 11 
mm. in length, projecting 6 mm. beyond the first incision (which itself 
projects 3 or 4mm. beyond this, though not clearly shown to do so in 
the reproduction). It penetrates both tables of the skull just above the 
wound, and terminates abruptly at the fracture, the relations being 
