This case has several points of interest, alike for the surgeon and the asylum physician, and may be worthy of record. It is not often that trephining is had resort to except in cases of serious external injury, and then generally at the time of the accident. In the present instance, the mental symptoms dated from the time the patient received a blow on the head, and they disappeared quickly after the operation—nineteen months later. Although it would be absurd to say that the cure of the patient could be due to nothing but the operation, I think it is a fair and reasonable inference that the trephining was the means of restoring the man to health. Subjoined are the principal facts in the history of the case:—
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