usually
self-inflicted, but a suicide may elect to blow off the back of his
head. A wound in the back may be met with in a sportsman who indulges in
the careless habit of dragging a loaded gun after him. If a revolver is
found tightly grasped in the hand it is probably a case of suicide,
whilst if it lies lightly in the hand it may be suicide or homicide. If
no weapon is found near the body, it is not conclusive proof that it is
not suicide, for it may have been thrown into a river or pond, or to
some distance and picked up by a passer-by.

A bullet penetrating the skull even from a distance of 3,000 yards may
act as an explosive, scattering the contents in all directions; but the
bullet from a revolver will usually be found in the cranium.

The prognosis depends partly on the extent of the injury and the parts
involved, but there is also risk from secondary haemorrhage, and from
such complications as pleurisy, pericarditis, and peritonitis. Death may
result from shock, haemorrhage, injury to brain or important nervous
structures.

XIV.--WOUNDS OF VARIOUS PARTS OF THE BODY

1. =Of the Head.=--Wounds of the scalp are likely to be followed by (1)
erysipelatous inflammation; (2) inflammation of the tendinous
structures, with or without suppuration. A severe blow on the vertex may
cause fracture of the base of the skull. Injuries of the brain include
concussion, compression, wounds, contusion, and inflammation. Concussion
is a common effect of blows or violent shocks, and the symptoms follow
immediately on the accident, death sometimes taking place without
reaction. Compression may be caused by depressed bone or effused blood
(rupture of middle meningeal artery) and serum. The symptoms may come on
suddenly or gradually. Wounds of the brain present very great
difficulties, and vary greatly in their effect, very slight wounds
producing severe symptoms, and _vice versa_. A person may receive an
injury to the head, recover from the first effects, and then die with
all the symptoms of compression from internal haemorrhage. This is due to
the fact that the primary syncope arrests the haemorrhage, which returns
during the subsequent reaction, or on the occurrence of any excitement.
Inflammation of the meninges or brain may follow injuries, not only to
the brain itself, but to the scalp and adjacent parts, as the orbit and
ear. Inflammation does not usually come on at once, but after variable
periods.

2. =Injuries to