ingle fragment (fig. 70). A flap was raised in
the frontal region, where a scale of outer table (fig. 71),
clothed with diploic tissue, was found loose. Beneath this a
puncture on the frontal bone, about corresponding in size to
the bullet, was discovered. This opening was enlarged, and a
bullet detected and removed. The bullet was a Guedes, with no
marks of rifling, and was in no way deformed. At least a square
inch of the right frontal lobe was pulped, so that the bullet
lay in a cavity.

The patient improved somewhat during the next two days, and on
the third took a 16 hours' journey to Bloemfontein, where Mr.
Bowlby (who was present at the operation) kindly took him into
the Portland Hospital. The pulse gradually rose to 112, the
temperature remained on an average from 102 deg. to 103 deg., the
respiration rose to 36, the face became somewhat livid, and on
the sixth day death occurred rather suddenly, apparently from
respiratory failure. For two days before his death the patient
sometimes asked for food, &c.; there was occasional twitching
of the left angle of the mouth, and, when the posterior wound
was manipulated, some twitching of the fingers of the left
hand. When the wound was dressed on the fourth day, there were
breaking-down blood-clot and signs of incipient suppuration.

Mr. Bowlby made a _post-mortem_ examination, and found
considerable pulping of the tip of the right frontal and left
temporo-sphenoidal lobes, and a thick layer of haemorrhage
extending over the whole base of the brain.

[Illustration: FIG. 71.--Scale of outer table of Frontal Bone and
Diploe. Exact size, from fracture shown in fig. 72]

[Illustration: FIG. 72.--Perforating Fracture of Frontal Bone from
within Separation of plate outer table. (Low velocity.) 1/2]

The injury to the _cranial contents_ varied with the degree of bone
injury. Haemorrhage on the surface of the dura may in rare instances have
been the sole gross lesion; I never met with such a condition, however.
In all the cases in which comminution had occurred, some laceration of
the dura, even if not more than surface damage or a punctiform opening,
had resulted. In the more serious gutter fractures an elongated rent of
some extent usually existed. In the perforating fractures two more or
less irregular openings were the rule. The amount of haemor