tre of
the wound corresponded with the position of the fissure of
Rolando. The patient was struck at a distance of fifty yards
while kneeling; he fell and remained unconscious an hour and a
half. Right hemiplegia without aphasia followed. The wound was
cleansed and sutured, and in three days both arm and leg could
be moved, after which time the man improved rapidly. Three weeks
later when I saw him at Wynberg there was still comparative
weakness of the right side, but beyond some neuralgia of the
scalp, the man considered himself well. No groove could be
detected on the bone on palpation. (This case offers a good
example of the ease with which bone injury may be overlooked.
The man came over to England 'well;' but while on furlough, two
pieces of bone came away spontaneously. He is now again on
active service.)

_Compression._--Equally rare was it for pure symptoms of compression to
be exhibited. This depended on two circumstances: first, the rarity of
injuries giving rise to meningeal haemorrhage; secondly, the fact that in
nearly every case a more or less extensive destructive lesion was
present, at the margins of which less completely destroyed tissue
remained, capable of giving rise to symptoms of irritation. Again, as we
have seen, free haemorrhage into, or from the walls of, the cavities
produced in the brain was not a marked feature, and beyond this the
large defect in the cranial parietes was calculated to render a high
degree of compression impossible.

As the most serious head injuries presented a remarkable similarity in
their symptoms, I will shortly summarise their common features.

Every degree of mental stupor up to complete unconsciousness was met
with, but in some instances where the pulse, respiration, and general
bodily condition pointed to speedy dissolution, the patients answered
rationally often between moans or cries indicative of pain.

Widespread paralysis often existed, but this was seldom completely
general; more commonly it was combined with extreme restlessness of the
unparalysed parts, or sometimes, even when the whole of one hemisphere
was tunnelled, and in all probability widely destroyed, restlessness was
the only symptom. In some cases twitching of the features or the limbs
or severe convulsions were superadded.

The pupils were rarely unequal, and at the stage in which these patients
were first seen were usuall