rhage, even if
the venous sinuses were implicated, was on the whole surprisingly small,
when the cases were such as to survive the injury long enough to be
brought to the Field hospital. I never saw a typical case of middle
meningeal haemorrhage, although many fractures crossing the line of
distribution of the large branches came under observation. Case 60, p.
274, illustrated the fact that the osseous lesions of lesser apparent
degree are sometimes the more to be feared in the matter of haemorrhage,
as compression is more readily developed.

The degree of injury to the brain depended on the depth of the track,
the resistance offered by the bones of any individual skull, the weight
of the patient, but chiefly on the degree of velocity retained by the
bullet. It was sometimes slight and local as far as symptoms would guide
us; but in the majority of cases out of all proportion to the apparent
bone lesion, if the range was at all a short one. Cases illustrative of
these injuries are included under the heading of symptoms.

It will be, of course, appreciated that the coarse brain lesions under
the third heading differed in localisation and in extent alone, and in
no wise in nature, from those observed in the two preceding classes. The
damage consisted in direct superficial laceration and contusion, and
beyond the limits of the area of actual destruction, abundant
parenchymatous haemorrhages more or less broke up the structure of the
brain, such haemorrhages decreasing both in size and number as
macroscopically uninjured tissue was reached. No opportunity was ever
afforded of examining a simple wound track in a case in which no obvious
cerebral symptoms had been present.

IV. _Fractures of the base._--In addition to the above classes, a few
words ought to be added regarding the gunshot fractures of the base of
the skull. These possessed some striking peculiarities; first in the
fact that they might occur in any position, and hence differed from the
typically coursing 'bursting' fractures we are accustomed to in civil
life as the consequence of blows and falls, and consequently were often
present without any of the classical symptoms by which we are accustomed
to locate such fissures. Secondly, the peculiar form was not uncommon in
which extensive mischief was produced from within by direct contact of a
passing bullet.

As far as could be judged from clinical symptoms, indirect fractures of
the base such as we are accust