[Illustration: Plate 79.] SHRAPNEL--PLATE 79. HEAD. Gunshot Fracture of the Left Maxilla, with Lodgment of the Missile in the Neck Behind the Angle of the Jaw. Wound of entrance, below infraorbital ridge, with course through the mouth. Wound of exit, none. Missile left a few small metallic fragments spattered on the bone at the point of entrance. There is slight mark of deformity of the missile caused by its contact with the bone, shown in its shadow in the plate. The distinct outline and normal size of the ball shows it to have been on the side next to and near the plate. Treatment indicated is expectant. Results in such cases are favorable, as seat of probable infection is readily accessible. In this particular case, recovery followed with the ball left _in situ_, without causing the patient trouble enough to induce him to permit interference. [Illustration: Plate 80.] SHRAPNEL--PLATE 80. HEAD. Gunshot Fracture of the Anterior Table of the Frontal Sinus, with Lodgment of the Missile in the Posterior Nares. Wound of entrance, over the left internal super supra-orbital ridge, with course downward, slightly backward, and slightly to the left posterior nares. Wound of exit, none. The distinct outline and practically normal size of ball shows that the patient’s face was superimposed on the photographic plate, as the anterior location of the missile was suspected. The slight deformity of the ball is due to the impact with the bone. This personal case was received from the service of Prof. De Page, of the Belgian Red Cross Mission, at Josh Keshla Hospital, Constantinople, after an operation for infections of the frontal sinus, in which the anterior table was entirely removed, with free drainage into the posterior nares, before the radiograph was made or the exact location of the ball suspected. The missile is seen in the nares--very near the face--probably in the middle meatus, in the inferior turbinates, against the septum, deviated by its lodgment. Convalescence was finally established and the frontal-sinus wound practically closed when, without any subjective symptoms, an obstruction was objectively determined in the left posterior nares, suggesting the radiograph. The patient was so entirely free from any symptoms of the lodged missile that he wisely refused any meddlesome interference. He was discharged with sinus wound closed very remarkably without indication for plastic operation and with no symptoms. [Illustration: Plate 81.] SHRAPNEL--PLATE 81. HEAD. Gunshot Fracture of Anterior Table of the Parietal Bone and the Vomer, with the Lodgment of the Missile in the Posterior Nares. This plate is a side view of the case in plate No. 80, showing the antero-posterior location of the ball. The indefinite outline and enlarged size of the ball shows the ball to have been farther away from the plate than in plate 80. [Illustration: Plate 82.] SHRAPNEL--PLATE 82. UPPER EXTREMITY.