ACCIDENTS AND OPERATIONS. 347 



rib penetrate the cavity of the chest, it is advisable that the 

 ingress of air should be prevented as much as possible ; and 

 the patient must be treated antiphlogistically. Perfect 

 quietude is absolutely necessary. 



Fracture of the Cranium is, under any circumstances, of 

 serious consequence ; compression of the brain is likely to* 

 ensue, from the fractured portions bulging inwards, or from 

 extravasation of blood on the brain. 



The following case, which came under the care of Pro- 

 fessor Simonds, is recorded by Youatt : — "Two gentlemen 

 were playing at quoits, and the dog of one of them was struck 

 on the head by a quoit, and supposed to be killed. His 

 owner took him up and found that he was not dead, although 

 dreadfully injured. It being near the Thames, his owner 

 took him to the edge of the river, and dashed some water 

 over him, and he rallied a little. Professor Simonds detected 

 a fracture of the skull, with pressure on the brain, arising 

 from a portion of depressed bone. The dog was perfectly 

 unconscious, frequently moaning, quite incapable of standing, 

 and continually turning round upon his belly, his straw, or 

 his bed. It was a case of coma ; he took no food, and the 

 pulsation at the heart was very indistinct. 



" I told the proprietor that there was no chance of re- 

 covery, except by an operation ; and even then, I thought it 

 exceedingly doubtful. I was desired to operate, and took 

 him home. 



" The head was now almost twice as large as when the 

 accident occurred, proceeding from a quantity of coagulated 

 blood that had been effused under the skin covering the skull. 

 I gave him a dose of aperient medicine, and on the following 

 morning commenced my operation. 



"The hair was clipped from the head, and an incision 

 carried immediately from between the eyebrows to the back 

 part of the skull, in the direction of the sagittal suture. An- 

 other incision was made from this to the root of the ear. 

 This triangular flap was then turned back, in order to remove 



