Fissured fractures, when the fissure extends through the skull, usually result from injuries by shell. The passage of a ball may fracture and very slightly depress a portion of the outer table of the cranium, and then the line of fracture will very closely simulate fissured fracture extending through both tables, and the diagnosis between them be excessively doubtful. When fissured fracture exists, the distance to which it may be prolonged is often quite unindicated by symptoms, and its extent is very uncertain. Fissures often extend to long distances. They may occur at a part remote from the spot directly injured. In the case of a lieutenant of the 11th Hussars, who was apparently slightly wounded at Balaklava in the middle of the forehead by a piece of shell, a fissured fracture was found, after death, across the base of the skull, quite unconnected with the primary wound, and seemingly from _contre–coup_. Death resulted from inflammation and suppuration set up near this indirectly–injured part. Fissured fracture of the inner table may also occur from the action of a ball without external evidence of the fracture. Such a case occurred in the 55th Regiment, in the Crimea. The soldier had a wound of the scalp along the upper edge of the right parietal bone. The ball in passing had denuded the bone; but there was no depression. The man walked to camp from the trenches without assistance, and there were no cerebral symptoms on his arrival at hospital; but five days afterward there was general edema of the scalp and right side of face, the wound became unhealthy, and slight paralysis appeared on the left side. The next day hemiphlegia was more marked, convulsion and coma followed, and he died on the thirteenth day after the injury. Pressure from a large clot of coagulum and extensive inflammatory action were the immediate causes of death; but a fissure, confined to the inner table, running in line with the course of the ball, was also discovered. A preparation of the calvarium in this case was presented by Dr. Cowan, 55th Regiment, to the museum at Fort Pitt. The cases where comminution has resulted from the track of a ball across the skull generally present less unfavorable results than those where a single fissured fracture, extending through both tables, exists. The small, loose fragments can be removed; and if the dura mater be intact, the case, with proper care to prevent inflammatory action, may not improbably be attended with a favorable recovery.