Fractures of the Skull. 53 



rent. This is to be accounted for on the principle of counter 

 fissure" (Sir Charles Bell). B. C. 1. 2. M. 6. 



3. 36. Comminution of the Skull resulting" from a Fall. 



— Calvarium of a man — macerated — showing a very great 

 comminution of the right side and fissures on the left. 



The patient was leaning out of a window in a court in the High 

 Street. He lost his balance, and, after falling about thirty feet, landed 

 on his head on the stone pavement below. He was brought at once to 

 the Infirmary, but when admitted seemed to be dying. His head was 

 flattened on the right side, and his right eye protruded from the orbit. 

 There was no bleeding from ears, nose, or pharynx. A prominence in 

 the back of the pharynx was taken to be a dislocation of the cervical 

 vertebrte, and an unsuccessful attempt was made to reduce it. His pulse 

 was slow and weak, and his breathing shallow and irregular. He died in 

 about half an hour after the accident. 



The amount of comminution is indicated by the number 

 of wires necessary to hold the fragments together, after the soft 

 parts were removed. The following specimen is the other part 

 of this skull. G. C. 3094. 



Presented by Macdonald Browk, F.R.C.S.E. 



3. 37. Extensive Comminution of the Skull. — Base of the 

 skull, with the three upper cervical vertebrae from the same 

 patient as the previous specimen was taken from. The soft parts 

 have been removed, except the dura mater and some ligaments. 



The anterior fissure seen passing forwards on the right side 

 in the previous specimen can now be traced into the frontal 

 bone, and thence downwards in the roof of the right orbit, to 

 end in the mesial line near the foramen magnum. The roof 

 of the right orbit and the outer wall of the right middle fossa 

 are greatly comminuted. 



The right malar bone was broken, and a fissure (enlarged 

 accidentally in cleaning the bone) involved the right half of 

 the palate. On the left side there is a fissure beginning just 

 above the external auditory meatus, and running irregularly 



