ly
corresponding to the point of exit of the bullet was carried altogether
away, but around this point a number of large irregularly shaped
fragments of bone, from 3/4 to 1 inch in diameter, were found loose, and
often so displaced as to expose a considerable area of the dura-mater.
Beyond the area of these loose fragments, fissures extended into the
base and vertex, in the latter case often being limited in their extent
by the nearest suture.

Over extensive fractures of this nature general oedema and
infiltration of the scalp, due to extravasation of blood, were present.
When the exit was situated in the frontal region ecchymosis often
extended to the eyelids and down the face, while in the occipital region
similar ecchymosis was often seen at the back of the neck.

The opening in the dura mater at the aperture of entry was either
slitlike, or more often irregular from laceration by the fragments of
bone driven in by the bullet. At the point of exit a similar limited
opening corresponded with the spot at which the bullet had passed, while
separate rents of larger size were often seen at some little distance.
The latter were the result of laceration of the outer surface of the
membrane by the margins of the large loose fragments of bone above
described.

Injury to the brain more than corresponded in extent to the fractures of
the bone. Pulping of its tissue existed over a wide area both at the
points of entrance and of exit. In the former position the amount of
damage was the less, the gross changes roughly corresponding with the
tissue directly implicated by the bullet itself, and the fragments of
bone carried forward by it. The degree of splintering of the skull
therefore in great part determined the severity of the lesion. At the
exit aperture much more widespread destruction existed, while masses of
brain tissue, small shreds of the membranes, fragments of bone, and
_debris_ from the scalp were found occasionally bound together by
coagulated blood and protruding from an exit opening of some size. The
largest masses of such _debris_ were most often seen in instances in
which the bullet had entered by the base to escape at the vertex of the
skull.

The brain in the line of injury suffered comparatively slightly, but
small parenchymatous haemorrhages into its tissue indicated in lesser
degree the same type of injury undergone by the mass of brain pulp and
small blood-clots found at the external limits of the woun