The whole frontal bone was driven deeply into the brain, yet, strange to say, the See Addenda to Ihe last edition of Mr. Guthrie's Commentaries. I.N.I! TIIK HEAD. 1M poor sufferer lived i'.r twenty-four hours after sucli;i wound. ENnofd-Cttftfl sometimes, as is well known, slice away parts of the.skull. These portions will, at times, re-ad. ifimmediately applied. In the museum of the Val de (i nil remarkable examples of this are to be I had under my charge, after the fall of Sebas1, a Russian soldier who had received such a wound, although the bone was not entirely detaehed in his case. The left parietal bone was cleft, so as to be almost separated. He would allow no one to touch his wound, pt a comrade.
His recovery was complete, the brain never showing any tendency to protrude, although ijiiite visible throughout the whole extent of the wound. I saw this Russian in the interior, after peace, in perfect health. The comparative rarity of hernia of the cerebral substance alter sword, as compared with gun-shot wounds, is very remarkable. its from a blunt sword are peculiarly dangerous, from the extensive splintering and depression of the inner table which so commonly result s.f -s several such cases at length, from L-'ault.', Plat nor, and f Inat trephining does little good in these cases, is illustrated by the practice of Deate, who had unlrr his charge many mm Bounded l>y the "hanger," in all the street frays <.f of tin- seven
Intrephined died: while in thr only four in which be teems not to have interfered, recovery followed In aca.v not caused by a sword, was a similar description, and which occurred lately in the Usal Infirmary of i!n under Mr. l.yi;, the recovery was probably ow in to tin- nn int. rferaooe with the injured bone, further than tli> n A nun aged 19 was admitted on th. JM!I <>f.Inly. had been struck on the head by the handle of a crane, and tip- i < 'FMMIIAN WAR. One of the most remarkable circumstances connected with gun-shot wounds of the head is, that they are not more universally followed by concussion, or that the symptoms of concussion, when produced, are often so temporary in duration.
I have been frequently told by men who had received wounds of considerable severity, that they experienced merely feelings of passing "weakness " when struck. Symptoms of concussion, however, more generally follow severe blows, and the gradual. and almost insensible manner in which this state passes into one of compression or of inflammation, and that into consequitive compression, forms one of the most treacherous and dangerous features of these cases. It is evidently a matter of much importance to those who advocate trephining in certain circumstances, to be able to distinguish accurately between these variable condihead, with the exception of the anterior part, separated. The bone was fractured into small pieces, to the extent of four inches by one and a half, over the right side of the head the fracture slanting obliquely over the orbit.
He suffered much from the shock when admitted, but replied to questions put to him. Bony spiculae were driven into the right eye, the right malar bone was broken, and the frontal sinuses opened. The loose and broken bones were removed, when the brain was found to be laid bare to the extent of three inches, and the dura mater destroyed. Low diet, purging, and cold locally, were the remedies the scalp being carefully laid down, and the spiculae removed from the eye. The fractured bones were not interfered with, further than the removal of perfectly loose portions. A week after admission the brain began to protrude by the opening in the skull, but by gentle compression it soon receded, and the patient made a rapid recover}', interrupted only by a slight haemorrhage from a vessel in the scalp, which was easily suppressed.