When I came to Renfield’s room I found him lying on the floor on his left side in a glittering pool of blood.  When I went to move him, it became at once apparent that he had received some terrible injuries.  There seemed none of the unity of purpose between the parts of the body which marks even lethargic sanity.  As the face was exposed I could see that it was horribly bruised, as though it had been beaten against the floor.  Indeed it was from the face wounds that the pool of blood originated.

The attendant who was kneeling beside the body said to me as we turned him over, “I think, sir, his back is broken.  See, both his right arm and leg and the whole side of his face are paralysed.”  How such a thing could have happened puzzled the attendant beyond measure.  He seemed quite bewildered, and his brows were gathered in as he said, “I can’t understand the two things.  He could mark his face like that by beating his own head on the floor.  I saw a young woman do it once at the Eversfield Asylum before anyone could lay hands on her.  And I suppose he might have broken his neck by falling out of bed, if he got in an awkward kink.  But for the life of me I can’t imagine how the two things occurred.  If his back was broke, he couldn’t beat his head, and if his face was like that before the fall out of bed, there would be marks of it.”

I said to him, “Go to Dr. Van Helsing, and ask him to kindly come here at once.  I want him without an instant’s delay.”

The man ran off, and within a few minutes the Professor, in his dressing gown and slippers, appeared.  When he saw Renfield on the ground, he looked keenly at him a moment, and then turned to me.  I think he recognized my thought in my eyes, for he said very quietly, manifestly for the ears of the attendant, “Ah, a sad accident!  He will need very careful watching, and much attention.  I shall stay with you myself, but I shall first dress myself.  If you will remain I shall in a few minutes join you.”

The patient was now breathing stertorously and it was easy to see that he had suffered some terrible injury.

Van Helsing returned with extraordinary celerity, bearing with him a surgical case.  He had evidently been thinking and had his mind made up, for almost before he looked at the patient, he whispered to me, “Send the attendant away.  We must be alone with him when he becomes conscious, after the operation.”

I said, “I think that will do now, Simmons.  We have done all that we can at present.  You had better go your round, and Dr. Van Helsing will operate.  Let me know instantly if there be anything unusual anywhere.”

The man withdrew, and we went into a strict examination of the patient.  The wounds of the face were superficial.  The real injury was a depressed fracture of the skull, extending right up through the motor area.

The Professor thought a moment and said, “We must reduce the pressure and get back to normal conditions, as far as can be.  The rapidity of the suffusion shows the terrible nature of his injury.  The whole motor area seems affected.  The suffusion of the brain will increase quickly, so we must trephine at once or it may be too late.”