volving the mastoid process and the bony capsule of
the ear. Wounds of the mastoid process obtained their chief interest in
connection with paralysis of the seventh nerve. This nerve rarely or
never escaped, and, as far as my experience went, the facial paralysis
was permanent (see cases 111-114, p. 355). I think the same prognosis
holds good with regard to the deafness resulting from these injuries,
and it is difficult to believe, with our experience of the effect of
vibration on other nerve centres and organs, that the internal ear could
ever escape permanent damage.

In a number of cases the tympanum itself, or the external auditory
meatus, was directly implicated in tracks; in these, also, loss of
hearing was the rule.

Wounds of the pinna when produced by undeformed bullets were usually of
the same slitlike nature remarked in perforations of the cartilages of
the nose, and healed with equal rapidity.

_Wounds of the orbit._--Injuries to the orbit were very numerous and
serious in their results, both to the globe of the eye and the
surrounding structures.

_Anatomical lesions._--The wound tracks, with regard to the injuries
produced, may be well classified according to the direction they took;
thus--vertical, transverse, and oblique.

Vertical wound tracks were on the whole the least serious, but this
mainly from the fact of limitation of the injury to one orbital cavity.
They were usually produced by bullets passing from above downwards
through the frontal region of the cranium, and were received by the
patients while in the prone position.

Transverse and oblique wounds owed their greater importance to the fact
that both eyes were more likely to be implicated.

Besides these tracks, which actually crossed the cavities, a number
involved the bony boundaries, producing almost as severe lesions in the
globe of the eye, many of the patients being rendered permanently blind.
The only difference in nature of such cases was the escape of orbital
structures, and this was of minor importance in the presence of the
graver lesion to vision. The following is an illustrative case:--

(74) Wounded at Colenso. _Entry_ (Mauser), 1 inch below the
centre of the margin of the right orbit; _exit_, behind the
right angle of the mandible. Fracture of lower jaw, and
development of a diffuse traumatic aneurism of the external
carotid artery. The common carotid artery was tied for
secondary haemorrh