For the skin subcutaneous sutures of silk-worm gut are desirable. When the head has been opened for extensive oper ation, drainage is important. A piece of silver wire hooked in the lower angle of the wound, or a small drainage-tube will answer; if the latter, it should be re moved after twenty-four or forty-eight hours, unless abscess develop, when it ' should remain several days. A volumi nous dressing of sterile absorbent gauze secured by roller bandage or night-cap will afford protection and support. The time when dressings are to be changed will vary with the conditions present. As a rule, half the stitches may be re moved on the fifth or sixth day; the re . mainder by the seventh or eighth day. Absolute quiet of mind and body should be observed for the first week, and no visitors, letters, or other disturbance for two weeks at least.
In 104 craniectomies had 6 deaths. Of 57 adults operated upon no deaths from shook of operation; 3 died from sepsis: 1 from luiemo•rhage, and 2 from compli cations due to teething (one seven days, other ten days after operation). Pa tients removed from operating-table without showing any shock or unfavor able symptoms other than those follow ing serious operation. Electric saw used after trephine. Powell (Archives of Fed., May, '99).
Cerebral Localization. — In addition to the motor areas around the fissure of Rolando, operating surgeons should be familiar with the relations of the tem poro-sphenoidal lobe with ear disease; the supramarginal convolutions in puncture of the lateral ventricles; the angular convolution in word-blindness; the occipital lobe in lesions of sight; in fact, the relations of the whole brain, except the anterior extremities of the parietal lobes. Chiene, of Edinburgh,
suggests the following method of cere bral localization: Shave the head and find, in the median line of the skull, be tween the glabella (G) and the external occipital protuberance (0), the following points: The midpoint (if), the three fourths point (T), and the seven-eighths point (,S). Find also the external angu lar process (E) and the root of the zygoma (I') immediately above and in front of the external auditory meatus.
Having found these five points, join EP, PS, and ET. Bisect EP and PS at and /?; also bisect AB at C and draw CD parallel to AM. The pentagon (ACBRPN) corresponds to the temporo sphenoidal lobe, with the exception of its apex, which is a little in front of N. MDCA correspond to the Rolandic area, containing the fissure of Rolando, and the ascending frontal and the ascending parietal convolutions. A is over the an is at B. (For motor, speech, and special sensory areas, etc., see illustrations in TUEIORS OF THE BRAIN.) Diseases, Malformations, and Injuries Involving the Skull.