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MEDICAL STUDIES

31

with the " Charter " occurred at this time, and many people were hurt. I t was curious to observe the apparent cleanness of the cuts that were made through the scalp by the blow of a policeman's round truncheon.

It sometimes happened that a severe case was brought at night-time, which required higher surgical skill than could properly be expected in the house surgeon, who, though professionally qualified, was young, and therefore relatively unpractised. If the treatment of any such accident admitted of no delay, a messenger was dispatched to the house of the surgeon himself, to wake and bring him. One of these events made a great impression on me. It was that of a man, a small piece of whose skull had been depressed by something falling on his head and stunning him. He was brought in utterly unconscious, with the " stertorous " or snoring respiration characteristic of such cases. The mark had to be trepanned, so the surgeon was sent for. In the meantime everything was prepared for his arrival. The trepan is a hollow steel cylinder with teeth cut out of its lower rim, used to saw a circular wad out of the sound bone nearest to the fracture. A miniature steel crowbar is used to raise the depressed fragment, and a rod to lay across the sound bone as a fulcrum for the crowbar. I seem to see it all before me as I write. The brightly lighted room, the apparatus in order, the surgeon at work, the eager faces of the bystanders, and the utterly uncon= scious patient. The wad was cut out, the crowbar adjusted, and still the monotonous snore continued unchanged. Then pressure was put on the free end of the crowbar, the broken bit of skull was raised,