On Injuries of the Head   

PART 7

When a hedra, or dint of a weapon, takes place in a bone, there may
be a fracture combined with it; and provided there be a fracture,
contusion must necessarily be joined, to a greater or less extent,
in the seat of the dint and fracture, and in the bone which comprehends
them. This is the fourth mode. And there may be a hedra, or indentation
of the bone, along with contusion of the surrounding bone, but without
any fracture either in the hedra or in the contusion inflicted by
the weapon. But the indentation of a weapon takes place in a bone,
and is called hedra, when the bone remaining in its natural state,
the weapon which struck against the bone leaves its impression on
the part which it struck. In each of these modes there are many varieties,
with regard to the contusion and fracture, if both these be combined
with the hedra, or if contusion alone, as it has been already stated
that there are many varieties of contusion and fracture. And the hedra,
or dint, of itself may be longer and shorter, crooked, straight, and
circular; and there are many varieties of this mode, according to
the shape of the weapon; and they may be more or less deep, and narrower
or broader, and extremely broad. When a part is cleft, the cleft or
notch which occurs in the bone, to whatever length or breadth, is
a hedra, if the other bones comprehending the cleft remain in their
natural position, and be not driven inwards; for in this case it would
be a depression, and no longer a hedra.

PART 8

A bone may be injured in a different part of the head from that on
which the person has received the wound, and the bone has been laid
bare. This is the fifth mode. And for this misfortune, when it occurs,
there is no remedy; for when this mischief takes place, there is no
means of ascertaining by any examination whether or not it has occurred,
or on what part of the head.

PART 9

Of these modes of fracture, the following require trepanning: the
contusion, whether the bone be laid bare or not; and the fissure,
whether apparent or not. And if, when an indentation (hedra) by a
weapon takes place in a bone it be attended with fracture and contusion,
and even if contusion alone, without fracture, be combined with the
indentation, it requires trepanning. A bone depressed from position
rarely requires trepanning; and those which are most pressed and broken
require trepanning the least; neither does an indentation (hedra)
without fracture and contusion require trepanning; nor does a notch,
provided it is large and wide; for a notch and a hedra are the same.

PART 10

In the first place, one must examine the wounded person, in what part
of the head the wound is situated, whether in the stronger or weaker
parts; and ascertain respecting the hairs about the wound, whether
they have been cut off by the instrument, and have gone into the wound;
and if so, one should declare that the bone runs the risk of being
denuded of flesh, and of having sustained some injury from the weapon.
These things one should say from a distant inspection, and before
laying a hand on the man; but on a close examination one should endeavor
to ascertain clearly whether the bone be denuded of flesh or not;
and if the denuded bone be visible to the eyes, this will be enough;
but otherwise an otherwise an examination must be made with the sound.
And if you find the bone denuded of the flesh, and not safe from the
wound, you must first ascertain the state of the bone, and the extent
of the mischief, and of what assistance it stands in need. One should