been studied and described by numerous travelers. The process commences immediately after the birth of the child, and is continued for a period of from eight to twelve months, by which time the head has permanently assumed the required form, although during subsequent growth it may partly regain its proper shape. "It might be supposed," observes Mr. Kane, who had large opportunities of watching the process, "that the operation would be attended with great suffering, but I never heard the infants crying or moaning, although I have seen their eyes seemingly starting out of the sockets from the great pressure; but, on the contrary, when the thongs were loosened and the pads removed, I have noticed them cry until they were replaced. From the apparent dullness of the children while under the pressure, I should imagine that a state of torpor or insensibility is induced, and that the return to consciousness occasioned by its removal must be naturally followed by a sense of pain."
Nearly, if not all, the different fashions in cranial deformity, observed in various parts of the world, are found associated within a
Fig. 11.—Cranium of Koskeemo Indian, Vancouver Island, deformed by circular constriction and elongation. (Museum of the Royal College of Surgeons.)
very small compass in British Columbia and Washington Territory, each small tribe having often a particular method of its own. Many attempts have been made to classify these various deformities, but as they mostly pass insensibly into one another, and vary according as the intention has been carried out with a greater or less degree of perseverance and skill, it is not easy to do so. Besides the simple occipital and the simple frontal compressions, all the others may be grouped into two principal divisions. First (Figs. 8 and 9), that in which the skull is flattened between boards or other compressors, applied to the forehead and back of the head, and as there is no lateral
