CASE.—Private Edward V——, Co. D, 55th Ohio
Volunteers, was wounded at the battle of Bull Run, Virginia, August 29th, 1862, by a conoidal ball,
which struck half an inch above the right eyebrow,
and the same distance from the median line of the
os frontis, comminuting and carrying away both
tables to the extent of one and one-fourth to two
and one-fourth inches. He was wounded while in the
act of discharging his gun, staggered considerably
under the shock, but recovered immediately, so
that he fired, loaded, and fired a second time
before he fell. He lay on the field for six days,
during which time a considerable amount of brain
matter oozed from the wound. He was afterward
conveyed to Washington, and admitted, on the 7th
of September, into the Emory Hospital, where the
wound was dressed for the first time. Half of the
plates composing the frontal sinus were found
turned in upon the brain, and about one-third of
the ball was battered up against the fractured
edge of the bone. When the missile and fragments
of bone were removed a large quantity of fœtid
pus and a teaspoonful of cerebral matter exuded.
The most remarkable feature of the case was that
there were no symptoms of injury to the brain,
either in articulation, memory, sight, or
animation. The wound was dressed with adhesive
strips to keep the eyebrow from falling on the
cheek. On the morning of the 8th, a hernia
cerebri, an inch in diameter, made its appearance,
pulsating with the heart's action. The depressed
walls of the frontal sinus were now removed by
Assistant Surgeon J. D. Hall, 24th New York
Volunteers, the operation being attended with
slight hæmorrhage, a plentiful discharge of pus,
and the escape of a teacupful of softened brain
matter. On the 9th, the tongue was covered with a
thick white fur; lips red, pulse nearly normal. No
change occurred until the 19th, except that the
wound became more painful, though it continued
perfectly healthy. The hernia had gradually
receded when, on the 20th, a colliquative
diarrhœa set in, which, though arrested by
astringents and opiates greatly reduced his
strength; his mind, however, continued perfectly
clear. Tonics, with nouishing diet, were
administered, but he failed to rally, and died on
the morning of the 25th. At the autopsy a large
clot was found between the dura mater and the
skull, at the coronal suture; and the meninges and
brain exhibited a much greater degree of
congestion and inflammation than any recent
symptoms had indicated. The ventricles, on
section, were found filled with serum and pus. The
pathological specimen is No. 276, Sect. I, A. M. M. The cranium shows an extensive fracture of the
right supra-orbital arch; a small fragment of the
bone is attached. The entire arch is removed,
leaving an opening into the cranium, two and
one-half inches long and one and one-fourth wide,
extending from the inner angle of the orbit to the
anterior inferior angle of the right parietal. The
orbital plate of the right superior maxilla is
fractured and depressed and a fissure an inch long
extends down the body of the bone. The specimen
and history were contributed by Surgeon William Clendenin, U. S. V.