Excerpt from Clinical Surgical Diagnosis for Students and Practitioners When Dieffenbach summarized his views on trephining, in his classical work, some sixty years ago, before the question was definitely settled, he wrote as follows: - "Up to quite recently it was the first urgent duty of the surgeon, immediately after the injury, to make a large crucial incision, and to search for fissures or fractures. Occasionally I found on my arrival that the hairy portion of the head had been ploughed up by incisions, backwards and forwards, crucial and transverse. This was considered to be indispensable in all head injuries. A surgeon who had omitted to make the crucial incision would have incurred the same responsibility as one who failed to open the window in endeavouring to rescue a victim of coal gas suffocation." At that time there was no "cerebral diagnosis"; but nevertheless the surgeon's need for a diagnosis had to find some expression. To leave an injury to Nature, without knowing whether or not a fissure was present, was considered to be an unworthy and culpable piece of surgical inactivity, because the real danger of a fractured skull had not yet been clearly ascertained. Philosophical speculation took the place of observation, and therefore surgery for a long time was guilty of one of its greatest sins, in breaking the law primum nil nocere. We smile at this kind of diagnosis; but posterity will look upon some of our exploratory procedures, involving flaps of half the skull, much in the same way as we regard those meaningless "crucial and transverse incisions." The maxim "nil nocere" must be observed, not only in treatment, but also in examination. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.