bullet traversed the neck behind the
pharynx and oesophagus without injuring either viscus, and the escape
of the main vessels and nerves was equally striking. In such wounds the
wedge-like bullet without doubt separated and displaced all these
structures, causing mere superficial contusion.

In connection with the latter statement, the rarity of direct sagittal
wounds in the hospitals should be mentioned. This is probably to be
explained by the facts that wounds in the mid-line of the neck
implicated the cervical spinal cord, and that sagittal wounds
implicating the vessels were apt to lead more directly to the surface,
and thus external haemorrhage was favoured. A few examples of cervical
tracks will suffice to illustrate these remarks:--

(85) _Entry_ (Lee-Metford), below angle of scapula; _exit_,
centre of posterior triangle. Injury to the lung, and
haemothorax. No damage to neck structures.

(86) _Entry_ (Mauser), over Pomum Adami; _exit_, below right
scapular spine. Median and musculo-spiral paralysis.

(87) _Entry_, a large oval aperture through ninth right rib,
1/2 an inch external to scapular angle; _exit_, anterior border
of sterno-mastoid opposite Pomum Adami. Second entry, opposite
angle of mandible; exit, in centre of cheek.

Wound of lung. Musculo-spiral paralysis still persisting at the
end of nine months.

(88) _Entry_ (Mauser), 2 inches above left clavicle at margin
of trapezius; _exit_, 1 inch from sternum in left first
intercostal space. Contusion of brachial plexus, with mixed
signs, which disappeared in two months. No signs of vascular
injury.

See also cases of cervical aneurism, &c.

_Wounds of the pharynx._--I saw only three cases of wound of the
pharynx; in each the injury was in the nasal or buccal segment of the
cavity, and in each the soft palate was injured, in two instances the
wound being a small perforation.

All three cases belong to the somewhat miraculous class. The first (89)
was the only one in which the wound gave rise to subsequent trouble. The
second was under the charge of Mr. Bowlby, and will no doubt be more
fully recounted by him, as interesting signs of injury to the cervical
cord were present. In the third the occipital neuralgia was the only
troublesome symptom.

In both cases 90 and 91 the high position of the wound in the fixed
portion of the pharynx no doubt accounted for the abs