pioneer of neurosurgery. Pringle's casebooks demonstrate the standard skull charts he devised for the recording of head injuries and the precise site and extent of skull fractures. In these casebooks he recorded the levels of consciousness, meticulous neurological examinations and fundoscopy which he had performed in such cases. These casebooks, neatly written and with meticulous coloured illustrations, offer an insight into the mind of a surgeon who was both painstaking and methodical. Malignant melanoma In 1908, Pringle published the first description of en-bloc excision for malignant melanoma, reporting the procedure in two patients. Some thirty years later he was able to publish a follow-up reporting two of these cases alive and well, 30 and 38 years on. His description of en-block excision is much as is practised today and appears to be the first description of what was to become an accepted surgical treatment. Reconstructive arterial surgery Pringle was the first surgeon in Britain to carry out a free vein graft. He did this using a saphenous vein graft to restore continuity after excision of a syphilitic aneurysm of the popliteal artery and characteristically in this paper he duly acknowledged the "splendid work of Carrel". Alexis Carrel had been the first surgeon to make an arterial anastomosis, work which led to his being awarded the Nobel Prize in Physiology or Medicine in 1912. The technical quality of Pringle's operative technique is demonstrated by the fact that in this pioneering operation "not one drop of blood escaped at either of the lines of suture and distal pulses were instantly restored". The Pringle manoeuvre It is for the Pringle manoeuvre that his name remains known throughout the surgical world. The technique of occluding the portal triad to control haemorrhage in liver trauma which he described in the Annals of Surgery in 1908 is still widely used in modern hepatic surgery to minimise blood loss. Pringle's paper attests to the originality and logic of his thinking, often flying in the face of mainstream opinion. In describing his experience in dealing with liver injury he observed that portal triad occlusion controlled the bleeding from the liver sufficient to allow suturing or packing. "An assistant," he wrote, "held the portal vein and the hepatic artery between a finger and thumb and completely arrested all bleeding.” Later life Pringle served in the First World War as a major in the RAMC at number 4 General Hospital