it comes, I think, that the true "punctured less seen now in military practice than it Larrey thinks that in young persons a ball may enter the skull, a hole leas than itself; from the v i''! '!n!<!. in whom the bone is more brittle, and splinters. A case is related by Dr. f thr.'ih regiment, in the second volume of f,.r whi. h it would appear, that a ball may, nter the skull,.uxl its level by its resiliency so completely as to leave no trace of the passage of the part of the ball which entered. was formerly.
I state this, however, with much hesitation as it would require a larger number of observations than I possess to substantiate it. Balls striking the head otherwise than perpendicularly to its surface, or impinging against one of its anirlcs, may be split, part entering the skull, and part flying off. This occurred in cases which have been related by Mr. Wall of the 38th regiment, and by Dr. Longmore of the 19th.* Such instances are not uncommon in war. Larrey, following the half which entered, removed it by counter-opening from the back part of the head. One half of a split ball has been seen to lodge between the tables of the skull. The whole ball, also, has been found thus placed, especially at the fore part of the head.
There are various instances on record of a round ball penetrating the outer paries of the frontal sinus, without injuring the inner table; but I believe that no such instances will ever be found where a conical ball is used. It not only penetrates, but generally perforates the skull, and almost always proves fatal. The most dreadful in war are those occasioned by shell. Although rarely, yet it does at times happen, that this missile cuts open the scalp only, or merely grazes the bone; yet it more frequently occurs that large masses of the skull are driven by it into the brain. Examples will be afterwards given of shell wounds of the head. One of the most ghastly by a fragment of shell.