In the 18th century a surgeon called James Hill lived and worked in Dumfries in Scotland. He was a major contributor to the science of surgery and recorded much better results than his contemporaries both for cancer and head injuries. This book is concerned head injuries and his contribution to their management was widely admired in his time all over Great Britain. His fame persisted for over one hundred years after his death. Unfortunately, as he lived in Dumfries, a provincial town without a large institution to remember its important sons, he has subsequently been forgotten. The material which forms the foundation on which the medical part of this book is based has been acquired using a method not previously employed in the writings of medical historical texts. It may be called the technique of tabulation and time. In brief, the case histories of all the surgeons with series of patients have been analysed using the data to be found within the text. Thus, tables are made including date, age, gender, type of trauma, type of injury, time from injury to treatment, timing of complications, need for surgery, complications of surgery, survival, death, cause of death and others. Analysis of these tables has provided interesting new data, including precise definition of differences in practice, mortality rates and discrepancies between statements of intent and actual practice. This book is aimed at anyone interested in medical history and particularly the history of neurosurgery. It consists of three sections. The first section introduces some of the background in which Hill's life was passed. His family and he lived in politically dramatic times with stirring conflicts between various Christian denominations much like the internecine strife so characteristic of contemporary Islam. An outline of the social currents of his day gives some impression of the influences to which he would have been exposed. In the event, it would seem that the influences of his formative years had less effect on his behaviour than the influences of the Scottish Enlightenment. The second section outlines surgical practice and concepts during the eighteenth century. While this is only about context, for a modern reader so much of it is unfamiliar, a reasonably detailed description is necessary, or it is not possible to understand the contributions of a surgeon practising in the eighteenth century. In conclusion, the reader will hopefully find this a useful addition to current understanding of the seeds from which modern neurosurgery has grown and will enjoy, as the author has done, the rainy windswept town of Dumfries and its environs which form the backdrop for this account. Any surgeon knows the tyranny of the telephone when on duty and the tension a telephone bell can produce even when on holiday. In Hill's world there were no telephones, so he was spared that stress. On the other hand, an emergency involved someone walking or riding out on horseback over dreadful roads to call him to the home of a patient. It is documented he never failed to respond to such a summons. This taken together with his results surely makes him a man who deserves our respect, attention and remembrance