the wound seems practically healed, the stitches are
to be removed and the cure completed with simple dressings.

The signs and symptoms of fracture of the cranium are: Loss
of appetite and failure of digestion, insomnia, difficulty in
micturition, constipation, a febrile dyscrasia, difficulty in cracking
nuts or crusts of bread with the jaws, or severe pain when a string is
attached to the teeth and pulled sharply. If the meninges are injured
we have further: headache, a slow and irregular but increasing fever,
alternating with chills, distortion of the angles of the eyes, redness
of the cheeks, mental disturbances, dimness of vision, a weak voice
and bleeding from the ears or the nose. In the presence of such
symptoms the death of the patient may be expected within at most a
hundred days.

If the fracture of the cranium is accompanied by a large scalp wound,
any fragments of bone or other foreign body are to be extracted at
once, unless haemorrhage or the weakness of the patient are feared,
and then a piece of linen is to be cautiously worked in with a feather
between the cranium and the dura mater. In the fracture itself a piece
of linen, or better of silk, is inserted, the apparent purpose of this
double dressing being to protect the dura mater from the discharges
and to solicit their flow to the exterior. A piece of sponge,
carefully washed, dried and placed in the wound, Gilbert tells us,
absorbs the discharges satisfactorily and prevents their penetration
internally. Over the wound is placed a bit of linen moistened with
egg-albumen, then a dressing of lint, and the whole is maintained in
place by a suitable bandage. Finally the patient is to be laid in bed
and maintained in such a position that the wound will be dependent, so
as to favor the ready escape of the discharges. This dressing is to be
renewed three times a day in summer, and twice in winter. Proud flesh
upon the dura mater is to be repressed by the application of a sponge,
well-washed and dried, and if it appears upon the surface of the wound
after the healing of the fracture, it is to be destroyed by the use of
the hermodactyl. When the external wound is healed, the cicatrix is
to be dressed with the _apostolicon cyrurgicum_, an ointment very
valuable for the consolidation of bones, the leveling (_adaequatio?_)
of wounds, etc.

When the wound of the scalp is small, so as to render difficult the
determination of the extent of the fracture by explo