The remarkably modern ideas of Lanfranc of Milan (circa 1245-1315) concerning diagnosis, therapy and teaching are demonstrated by a case-history from his 'Chirurgia Magna' (AD 1296). Judging by the chapter on skull injuries, the advanced level of Lafranc's practice was not equalled by the later Middle Dutch authors such as Jan Yperman and Thomas Scellinck van Thienen.