Shell, grape, and sword wounds of the skull, afford examples of almost every kind of fracture. The nature of the injury, inflicted by a ball striking the skull, will depend chiefly on the angle of incidence, INJURIES or Tin: ii: nn-1 the velocity. The character of the hall, too, has more to do with tin' matter than is uvnrrally It' the direction of the projectile be very oblique to the surtace. and it' the force be exhausted at the moment of M5t, then the injury may be very slight a mere contusion of the snt't parts or of If the force be greater, then the may lie much injured. the bone considerably bruised, or slightly fractured throughout its whole thickness, or in one or other of its Tahles separately, the fracture of the inner sometimes taking place without any apparent injury of tin- outer. f Further, the brain may be injured as well as its case, when the blow is yet more direct or severe.
This injury may be merely of such a nature as, John Hell well says, " we choose to express our ignorance of by calling it a concussion." which may pass away, little harm. r which may be followed, at an uncertain interval. by encephalic inflammation, and compression from the efl'cct of a ball "brushing" over the skull be such, that while the bone is not fractured, the vessels between the skull and the dura mater may be ruptured, or the longitudinal sinus may be opened, as ease iii the Crimea, and which has been Stromeyer supposes that the danger of a grazing shot arises v.-ry mm h from pyaemia. Inflammation "f tinfi the diploe become implicated, and thus pus enters the system. f Preparation No.
2594 in the museum of lrt the manner in which part of the outer table of the skull may be nm shot injury, and Allows that the I table may be " considerably depressed, without corresponding depression of W.MI. related by the surgeon of the 19th regiment, in which it was observe A remarkable instance, showing how completely the skull may be destroyed by a glancing shot, without the scalp being implicated, occurred at the Alma. A round shot " en ricochet," struck the scale from an officer's shoulder, and merely grazed his head as it ascended. Death was instantaneous. The scalp was found to be almost uninjured; but so completely smashed was the skull, that its fragments rattled within the scalp as if loose in a bag.
The condition of the brain was, unfortunately, not examined. A bullet, from the great force with which it impinges upon the skull, and the concentration of that force on a small point, causes a fracture dissimilar to most of those which are met with in civil practice. It is this concentration of the force on a small point which renders fractures from a ball so dangerous, as the bone is driven deeply into the brain, and the splintering, especially of the inner table, is often very severe. The greater splintering of the inner than of the outer table, by a ball penetrating the skull from without, is explicable on the principles which interpret the difference between the wounds of entrance and of exit in the soft parts, and which I before explained by reference to a series of experiments on planks of wood.
The greater support afforded to the outer than to the inner table, by the parts lying behind it, and the diminished force of the ball as it passes through each, sufficiently account for the difference. An observation of Erichsen's on the. See Lancet, Vol. 1855. OF THE HEAD. 17'J poll; -upports this explanation, He has noticed that tin' characters of the apertures in the two tallies ened, m an I in which a man had committed suicide by shooting hiinselt' through the head mouth tinhall thus passing from within outwards. In i >m Bagieu, related by Sebatier, the same circumstance is noted in a similar The preparation in the Fort Pitt museum numbered 2592, illustrates the same thing.
In that case, a. hall had perforated the head, thus making two holes, the one in the tj and the other in the lateral and posterior part. The inner table of the orifice of exit is reirular, while outer " is torn up to an extent much larger than the ball." An appreciation of these distinctions is of much use to the medical jui character of the fracture caused in the skull by Large eonieal balls is, 1 am inclined to believe, conably different from that occasioned by the round ball. The destruction by them, of the outer table, ah appeared to me much greater than by the round ball; and thus, perhaps, it is that the size of the openin: wo tables is more equalized in the wounds < sioned by tin- former, than by the latter species of missile.