very near his bed. I immediately ordered a place to be prepared without for the stove, and to have it removed forthwith, which was accordingly done. Kind-hearted but thoughtless visitors were constantly coming to see the wounded. This was strictly forbidden; and quietude of body and mind was in in every possible way promoted.

As to the nature of the wounds I shall not speak with any great certainty. I found the patients placed in bed after having been examined by not a few medical gentlemen. It was not my duty to subject one of the poor but brave fellows to a moment's needless examination, to satisfy my curiosity. In the main I accepted the opinions that had been offered respecting the character of the wounds, and acted accordingly. Private White, who first came under my notice, I was told had received a ball through his left arm breaking the bone and entering the body, and was supposed to remain somewhere near the spine. Dr. Billings had placed the arms in splints; and ice water was being applied to the arm and also to the chest. The patient said this gave him great relief, and it was consequently continued. In the after part of the day his arm became very painful, and I removed one splint and placed the arm upon a pillow quite exposed and had ice directly applied. This gave him great relief.

Lieutenant Routh, I was told, had received a chest wound, and that the ball had pierced the lung and made its escape. I could not see the posterior wound, but from the situation of the anterior one, which was external to the heart, I thought it quite possible the lung had escaped. I found no symptoms of lung wound. The shock had evidently been severe to the unfortunate fellow, but from this he was rapidly rallying. From experience I had during the American war, I was enabled to offer a more favourable opinion than had been given before, which had a very happy effect upon him. Private Lugsten I found occupying a more comfortable room at the tavern. His brother and a few friends were giving him evidently too much attention. He was supposed to be very near his end, his case having been pronounced hopeless. His was also a wound of the chest, the ball having passed somewhat to the right side, perhaps at about the sixth rib. Here again I was led to doubt whether the ball had entered the lung. He was in a state of great excitement and restlessness, the pulse being in the neighbourhood of 140. I was inclined to attribute this in part, to the incessant conversation kept up respecting his own willingness to die. I at once told his brother that as he was well prepared to die it were much better to stop talking to him and keep the room very quiet. Quite contrary to the opinions which had been given, I said I certainly thought he might get well. I asked Dr. Allen, who was in immediate attendance what he was giving him, and he said nothing. I

Dr.

suggested something to lessen the heart's action, and inquired if he had antimony or digitalis, (I was then ignorant of the fact that Dr. Allen was a homeopath,) he replied no, but he had veratrum viride, which he said he would give in any dose I suggested. I saw Lugsten at a later hour of the day, when I found he had been resting-the action of the heart was much reduced; and there was a gentle moisture of the skin. At this time, accidentally hearing that Dr. Allen was a homeopath, I felt it my duty to say to that gentleman and to the brother of the wounded man, that I could not consistently continue in consultation. Allan replied that we were there as surgeons not as physicians. To this I said that medicines were required to control the heart's action, which I thought could not be done by infinitesimal doses. He said that was no dogma of homeopaths, and that he was not giving the medicines in such doses. The brother, who knew me very well when practising in Toronto, and who was a believer in homeopathy, earnestly begged me to remain in consultation. I pointed out to them that inasmuch as homeopaths professed to practice medicine upon theories directly antagonistic to ours, as they incessantly declared they had discovered a true theory which showed ours to be wrong, it would not only be inconsistent but absurd for us to consult together. I further said that if surgical interference were required I should, under the circumstances, sink my objections. However, at the earnest and renewed request of the brother I did call, as a friend, occasionally, while I remained at the place. I have fully stated these facts, because at the present time there is some feeling among the members of our profession against one or two who do not refuse to consult with homeopaths. I cannot conclude the matter without speaking of the very gentlemanly manner in which Dr. Allen conducted himself towards me. My time henceforward was confined to the two other wounded. By this time the small house in which lie my own patients, began to assume somewhat the appearance of comfort. Under the hands Lieut. Routh's brother, mother, and young wife, who had come since my arrival, much had been done, not for the brother alone, but the wounded comrade. Up to this time bread, butter and milk constituted the best of the food which could be procured, for the Fenians had thoroughly stripped every farm house; but now some beefsteak and eggs improved the appearance of the table, which was set in the wood-shed. Upon inquiry I learned that neither of my patients had a motion of the bowels for several days. I had not many drugs with me, and gave each a dose of calomel, and an anodyne draught. The house possessed but one bed beside those occupied by the men. This was brought by Mr. Routh. While this bed was set apart for the two ladies I am sure neither slept, from the fact that I always found one by

the side of the wounded. I was glad to be allowed to recline upon a short bench, having for a covering an outside coat which had belonged to one of the dead. I had found it necessaay to change the position of the arm of private White, after which he slept for some hours. Routh did not rest so well. Towards midnight the pulse of each was considerably increased in frequency; but this was in a few hours remedied, and in the latter part of the night they both rested tolerably well. Probably they would have rested better had it not been for the shameful conduct of a person in an officer's uniform, who having purloined a bottle of stimulant, made himself somewhat noisy. In striking contrast to him I must mention the kind nursing of an elderly lady, Mrs. Rebecca Danner, upwards of sixty-five, who lives within a mile of the battle-field. When our volunteers were advancing, she, like a prudent woman, at once thought they would be wanting bread, and set to work to bake for them; before she had completed this noble-hearted work, she was alarmed to see them retreating in some confusion. They rushed to her door demanding water! water! She and a young daughter, who indeed where the only females who had not left the neighbourhood, drew water for them-first one and then the other; and when there would be a lull, they would fill pails and vessels of every kind for the next that came; but, bye-and-bye, Fenians came. These suspicious wretches would not drink the water thus drawn, lest it had been poisoned, and the women were compelled to draw afresh. It is but justice to say that they treated Mrs. Danner and daughter unexceptionably. Shortly after Mrs. Danner set out for the battle field, and all the night long was engaged with others (among whom was her sister, a Mrs. Douglas, and a young lady) in administering to the wants of the agonized men. It was this Mrs. Danner who sat up the livelong night, and patiently and tenderly watched over private White, applying ice to the wounded arm and wetting the dry lips. In this connection I must mention the name of Dr. Brewster, who lives at Ridgeway, and who, when our forces retreated, advanced into the enemy's lines and did all he could for the brave fellows who had been left behind. He worked all the day and all the night, in connection with the brave, noble woman, to whom I have referred. The following morning I found the three men in all respects better. My own patients were particulary comfortable. The bowels had not yet moved, so I proceeded to administer an injection to each, having brought with me the necessary syringe. After repeating, each had a free evacuation. But I now felt it my duty to leave. Information reached us in the forenoon, direct from Toronto, that fighting had commenced below Kingston. As my fellow townsman had been ordered to that point, and my family lived in that region, I deemed it right that

I should depart, notwithstanding the interest I already felt in my patients. Mr. Routh at once acknowledged the superior claim, and immediately sent a telegraphic dispatch to Hamilton for Dr. Mullin to take my place. Before leaving I took every pains to make the men comfortable, and secured the willing promise of Dr. Brewster that he would see them every few hours until my successor arrived.

My short stay did not allow me to become fully acquainted with the course the balls had taken; but I left a note offering my opinion that in the case of private White, he ought to be very shortly put under the influence of chloroform and the fracture of the humerus thoroughly examined -that I believed the bone was badly shattered-that pieces would require removal-that very likely the fracture had extended into the shoulder joint and that amputation would be found necessary. According to the daily prints of Toronto this operation has subsequently been performed. By the same authority I have learned that the other patients are in a fair way of recovery.

I have to acknowledge the kindness of Mr. Spicer, of the Grand Trunk Company, in affording me facilities in going to and from the battle field. Belleville, 19th June, 1866.

Three Cases of Fracture of the Skull. BY THOMAS SIMPSON, M. D. Sault Ste. Marie.

THE following abridged notes of three cases of fracture of the skull seriously complicated, occurring in my practice within eighteen months, are, I think, of sufficient interest to warrant their publication, as furnishing additional instances of grave injury to the skull, unaccompanied or followed at least in two out of three-by constitutional disturbance of such consequence as to demand special consideration. Indeed in the last case in which the depression in the centre of the fracture considerably exceeded the thickness of the skull, and a circular portion of dura matter over an inch in diameter was completely destroyed and removed, there was not, from the commencement, any derangement of the functions of the nervous system, or any constitutional disorder. The danger to be apprehended in a case of this description is the supervention of diffuse menitgitis, which generally proves fatal. Always imminent, it almost invariably follows a comminuted fracture in this situation, if by any chance the careful and complete removal of every detached fragment of bone, or sharp projecting spicula in contact with the dura mater, be neglected.

In the case of L--, I think from the time and manner of recovery, we

may infer that the insensibility was owing in a great measure to alcohol; still I think the bleeding was warranted by the state of the skin, pulse, and the nature of the accident.

August, 1863. Called one evening to see L―, aged about 50 a confirmed drunkard, who I was told had been seen staggering into a stable about one hour previously, very drunk, and was found a short time afterwards lying insensible on the floor, and bleeding from the temple.

The following appearances were noted-face flushed, pupils dilated and sluggish, breathing slow and occasionally sterterous, pulse 60 and full, skin bathed in perspiration. Insensibility. almost complete, which his friends insisted was caused by drink. He frequently raised his hand to his head as if to arrange his cap, which he had been in the habit of wearing constantly, in order to conceal his baldness; no contraction of muscles, twitching or convulsion; liquid swallowed with little hesitation. A wound one inch in length situated on the left side of head, a little below the middle of the temporal ridge, and leading to a fracture having, from size and shape, evidently been inflicted by the calk of a horse's shoe: it extended through both tables, and the depression was very apparent. On removing the clots and washing the wounds, an artery commenced to bleed freely; the blood was allowed to flow until the pulse became reduced in volume. The wound was then dressed-cold applications to head. Directed an enema to be given at once, and to be followed in four hours by a dose of calomel and jalap. On the morning following he was sitting up somewhat excited; answered rationally when questioned; had been restless towards morning; had got up whenever the medicine operated; in short, he had the usual appearance and manner of a drunkard on the morning following an evening's debauch. One week after the accident he was walking about as usual; and in six weeks I met him on the road, drunkthe wound still discharging pus freely; in two months the wound had completely healed, leaving a marked depression.

November, 1863. Called to see C, a miner, aged 52 said to be seriously injured underground by a premature explosion. Note the following one hour after the accident-conciousness unimpaired, calm, pulse 58 and full, skin moist and cool, respiration natural, face contused and swollen; both eyes injured, the right slighly, the left completely destroyed, the humors having escaped. Wound immediately above the inner angle of left eye, about an inch in depth, extending through the orbital plate of frontal, and of sufficient width to admit of the easy introduction of the index finger. Extracted three loose fragments of bone. There was also a fracture of the sup. maxilla at their junction an inch and a half in breadth, displacing the alveolar and palate processes backwards,