A British soldier wounded at the Battle of Waterloo

This is one of a series of watercolours by the surgeon Charles Bell (1774-1842) of wounded soldiers from the battle of Waterloo. Bell had hurried from London to Brussels in June 1815 to assist in treating  the wounded; at the same time he filled a sketchbook with interesting cases which were subsequently worked up as watercolour paintings for teaching purposes.

This man had received a very serious gunshot wound to the skull, causing extrusion of brain tissue. The picture clearly shows the cross-shaped surgical cut of the skin around the wound, made in order to remove damaged bone fragments. Unfortunately such an injury provided an avenue for infection of the central nervous system which surgeons at the time were powerless to prevent. Sure enough this patient died six days after Bell sketched him. His staring eyes and flushed appearance are indicative of meningeal irritation, or inflammation of the lining of the brain.