On Injuries of the Head   

but it is less dangerous, and a matter of less consequence, when the
fissure has been effaced. But if the fracture extend deep, and do
not seem likely to disappear when scraped, such an accident requires
trepanning. But having performed this operation, you must apply the
other treatment to the wound.

PART 15

You must be upon your guard lest the bone sustain any injury from
the fleshy parts if not properly treated. When the bone has been sawed
and otherwise denuded, whether it be actually sound, or only appears
to be so, but has sustained some injury from the blow, there may be
danger of its suppurating (although it would not otherwise have done
so), if the flesh which surrounds the bone be ill cured, and become
inflamed and strangled; for it gets into a febrile state, and becomes
much inflamed. For the bone acquires heat and inflammation from the
surrounding flesh, along with irritation and throbbing, and the other
mischiefs which are in the flesh itself, and from these it gets into
a state of suppuration. It is a bad thing for the flesh (granulations?)
in an ulcer to be moist and mouldy, and to require a long time to
become clean. But the wound should be made to suppurate as quickly
as possible; for, thus the parts surrounding the wound would be the
least disposed to inflammation, and would become the soonest clean;
for the flesh which has been chopped and bruised by the blow, must
necessarily suppurate and slough away. But when cleaned the wound
must be dried, for thus the wound will most speedily become whole,
when flesh devoid of humors grows up, and thus there will be no fungous
flesh in the sore. The same thing applies to the membrane which surrounds
the brain: for when, by sawing the bone, and removing it from the
meninx, you lay the latter bare, you must make it clean and dry as
quickly as possible, lest being in a moist state for a considerable
time, it become soaked therewith and swelled; for when these things
occur, there is danger of its mortifying.

PART 16

A piece of bone that must separate from the rest of the bone, in consequence
of a wound in the head, either from the indentation (hedra) of a blow
in the bone, or from the bone being otherwise denuded for a long time,
separates mostly by becoming exsanguous. For the bone becomes dried
up and loses its blood by time and a multiplicity of medicines which
are used; and the separation will take place most quickly, if one
having cleaned the wound as quickly as possible will next dry it,
and the piece of bone, whether larger or smaller. For a piece of bone
which is quickly dried and converted, as it were, into a shell, is
most readily separated from the rest of the bone which retains its
blood and vitality; for, the part having become exsanguous and dry,
more readily drops off from that which retains its blood and is alive.

PART 17

Such pieces of bone as are depressed from their natural position,
either being broken off or chopped off to a considerable extent, are
attended with less danger, provided the membrane he safe; and bones
which are broken by numerous and broader fractures are still less
dangerous and more easily extracted. And you must not trepan any of
them, nor run any risks in attempting to extract the pieces of bone,
until they rise up of their own accord, upon the subsidence of the
swelling. They rise up when the flesh (granulations) grows below,
and it grows from the diploe of the bone, and from the sound portion,
provided the upper table alone be in a state of necrosis. And the
flesh will shoot up and grow below the more quickly, and the pieces
of bone ascend, if one will get the wound to suppurate and make it
clean as quickly as possible. And when both the tables of the bone