You start by rolling the dice in the saucer, if the dice rolls out of the saucer you have 1 skull (called a ballbag skull) once you have rolled you do the following If the die is a…… 1 Eveyrone must put the thumb on their forehead and say "Spastic Children" the last person to do so must skull after the person who rolled has rolled again this indicates how many skulls must be had. Unless they guess the number that was rolled, in that case they get to issue the skulls. 2 Person to the left skulls 3 Person to the right skulls 4 Person to the opposite of you skulls (if the is 2 it is the person closed to your left) 5 Self skull (the person who rolled must skull) 6 Nominate or issue the skulls to people. After the first roll to see what must be done you roll again to see how many skulls must be had. Just a warning played right this game will get you quite intoxicated.