148 MORBID ANATOMY.
Esq., a brother-in-law of his patient, Dr. Coon, Mayor of the city, and Dr. J. D. B. Stillman, all of San F.
The cranium arrived in this city, with the bar, in 1868, and have been most generously presented, by Dr. Harlow, to the Medical College.
On examination of the cranium, it is generally, though
not always, possible to distinguish between the bones that
are gone, as the result of the injury, and those that have
crumbled away and been lost since the man's death; the
smoothness of the edges determining this point for the
most part. The whole of the small wing of the sphenoid
bone upon the left side is gone, with a large portion of the
large wing, and a large portion of the orbital process of
the frontal bone ; leaving an opening in the base of the
skull, 2 in. in length, 1 in. in width, posteriorly, and taper-
ing gradually and irregularly to a point anteriorly. This
opening extends from the sphenoidal fissure to the situation
of the frontal sinus; and its centre is an inch from the
median line. The optic foramen, and the foramen rotun-
dum are intact. Below the base of the skull the whole
posterior portion of the upper maxillary bone is gone.
The malar bone is uninjured; but it has been very percep-
tibly forced outward, and the external surface inclines
somewhat outward, from above downward. The lower jaw
is also uninjured. The opening in the base above de-
scribed is continuous with a line of old and united fracture
that extends through the supra-orbitary ridge, in the situa-
tion of the foramen, inclines toward, and then from the
median line, and terminates in an extensive fracture that
was caused by the bar as it came out through the top of
the head. This fracture is situated in the left half of the
frontal bone, but, inferiorly, it extends somewhat over the
median line. In form it is about quadrilateral; and it
measures 2½ x 1¾ in. Two large pieces of bone are seen
to have been detached and upraised; the upper one having
been separated at the coronal suture from the parietal
bone, and being so closely united that the fracture does
not show upon the outer surface. The lower piece shows
the line of fracture all around. Owing to the loss of bone,
two openings are left in the skull; one, that separates the
