d commentary, adding to the value of the original work.

This is the well-known commentary of the Four Masters, a text-book of
surgery written somewhat in the way that we now make text-books in
various departments of medicine, that is, by asking men who have made
specialties of certain subjects to write on that subject and then bind
them all together in a single volume. It represents but another striking
reminder that most of our methods are old, not new as we are likely to
imagine them. The Four Masters took the works of Roger and Rolando,
acknowledged their indebtedness much more completely than do our modern
writers on all occasions, I fear, and added their commentaries.

Gurlt says ("Geschichte der Chirurgie," Vol. I, p. 703) that "in spite
of the fact that there is some doubt about the names of the authors,
this volume constitutes one of the most important sources for the
history of surgery of the later Middle Ages and makes it very clear that
these writers drew their opinions from a rich experience." It is rather
easy to illustrate from the quotations given in Gurlt or from the
accounts of their teaching in Daremberg or De Renzi some features of
this experience that can scarcely fail to be surprising to modern
surgeons. For instance, what is to be found in this old text-book of
surgery with regard to fractures of the skull is likely to be very
interesting to surgeons at all times. One might be tempted to say that
fewer men would die every year in prison cells who ought to be in
hospitals, if the old-time teaching was taken to heart. For there are
rather emphatic directions not to conclude because the scalp is
unwounded that there can be no fracture of the skull. Where nothing can
be felt care must be exercised in getting the history of the case. For
instance, if a man is hit by a metal instrument shaped like the clapper
of a bell or by a heavy key, or by a rounded instrument made of
lead--this would remind one very much of the lead pipe of the modern
time, so fruitful of mistakes of diagnosis in head injuries--special
care must be taken to look for symptoms in spite of the lack of an
external penetrating wound. Where there is good reason to suspect a
fracture because of the severity of the injury, the scalp should be
incised and a fracture of the cranium looked for carefully. That is
carrying the exploratory incision pretty far. If a fracture is found the
surgeon should trephine so as to relieve the brain of any p