ce with sufficient
force to produce serious nervous complications. When the injury occurs
at the base of the cranium hemorrhage may be looked for, with paralytic
symptoms, and when these are present the usual termination is death. It
may happen, however, that the symptoms of an apparently very severe
concussion may disappear, resulting in an early and complete recovery,
and the surgeon will therefore do well to avoid undue haste in venturing
upon a prognosis. In fractures of the orbital or the zygomatic bones the
danger is less pressing than with injuries otherwise located about the
head.

_Treatment._--The treatment of cranial fractures is simple, though
involving the best skill of an experienced surgeon. When incomplete
hardly any interference is needed; even plain bandaging may usually be
dispensed with. In the complete variety the danger to be combated is
compression of the brain, and attention to this indication must not be
delayed. The means to be employed are the trephining of the skull over
the seat of the fracture and the elevation of the depressed bone or the
removal of the portion which is causing the trouble. Fragments of bone
in comminuted cases, bony exfoliations, collections of fluid, or even
protruding portions of the brain substance must be carefully cleansed
away and a simple bandage so applied as to facilitate the application of
subsequent dressings.

FRACTURES OF THE BONES OF THE FACE.

In respect to their origin--usually traumatic--these injuries rank with
the preceding, and are commonly of the incomplete variety. They may
easily be overlooked, and may even sometimes escape recognition until
the reparative process has been well established and the wound is
discovered owing to the prominence caused by the presence of the
provisional callus which marks its cure. When the fracture is complete
it will be marked by local deformity, mobility of the fragments, and
crepitation. Nasal hemorrhage, roaring, frequent sneezing, loosening or
loss of teeth, difficulty of mastication, and inflammation of the
cavities of the sinuses are varying complications of these accidents.
The object of the treatment should be the restoration of the depressed
bones as nearly as possible to their normal position and their retention
in place by protecting splints, which should cover the entire facial
region. Special precautions should be observed to prevent the patient
from disturbing the dressing by rubbing his head against