n of the injury
except a scar near the edge of the hair on the upper part of the right
side of the forehead. Steele, in a school-boy of eight, mentions a case
of very severe injury to the bones of the face and head, with escape of
cerebral substance, and recovery. The injury was caused by falling into
machinery.

There was a seaman aboard of the U.S.S. "Constellation," who fell
through a hatchway from the masthead, landing on the vertex of the
head. There was copious bleeding from the ears, 50 to 60 fluid-ounces
of blood oozing in a few hours, mingled with small fragments of
brain-tissue. The next day the discharge became watery, and in it were
found small pieces of true brain-substance. In five weeks the man
returned to duty complaining only of giddiness and of a "stuffed-up"
head. In 1846 there is a record of a man of forty who fell from a
scaffold, erected at a height of 20 feet, striking on his head. He was
at first stunned, but on admission to the hospital recovered
consciousness. A small wound was found over the right eyebrow,
protruding from which was a portion of brain-substance. There was
slight hemorrhage from the right nostril, and some pain in the head,
but the pulse and respiration were undisturbed. On the following day a
fragment of the cerebral substance, about the size of a hazel-nut,
together with some brood-clots, escaped from the right nostril. In this
case the inner wall of the frontal sinus was broken, affording exit for
the lacerated brain.

Cooke and Laycock mention a case of intracranial injury with extensive
destruction of brain-substance around the Rolandic area; there was
recovery but with loss of the so called muscular sense. The patient, a
workman of twenty-nine, while cutting down a gum-tree, was struck by a
branch as thick as a man's arm, which fell from 100 feet overhead,
inflicting a compound comminuted fracture of the cranium. The right eye
was contused but the pupils equal; the vertex-wound was full of
brain-substance and pieces of bone, ten of which were removed, leaving
an oval opening four by three inches. The base of the skull was
fractured behind the orbits; a fissure 1/4 inch wide was discernible,
and the right frontal bone could be easily moved. The lacerated and
contused brain-substance was removed. Consciousness returned six days
after the operation. The accompanying illustrations (Figs. 196 and
197) show the extent of the injury. The lower half of the ascending
frontal co