aining. The patient was discharged from the
service on his return home.

In the upper part of the occipital region glancing or superficial
injuries were comparatively favourable; those near the base, especially
if perforating, were very dangerous. Two such cases are referred to
elsewhere. Case 69 is included as the only example of cerebellar injury
I happened to see who lived any appreciable time after the accident.

The main interest in these cases centres in the defects produced in the
area of the visual field. I am extremely indebted to my colleague, Mr.
J. H. Fisher, who has kindly determined this for me in three of the
following cases. It will be noted that in two instances the injury was
to the left occipital lobe. In these the resulting hemianopsia was of
the pure lateral homonymous character, and in both the visual symptoms
were accompanied by a certain degree of amnesic aphasia (65 and 68).

In 65 the injury was definitely unilateral, and at the time of the
operation I decided that at least an inch and a half of the posterior
extremity of the left occipital lobe was totally destroyed.

In 68 the lesion was probably confined to the left lobe, but it is
impossible to exclude slight injury to the right lobe also. In this
instance amnesic aphasia was a far more marked symptom than in 65, and
the position of the lesion suggested damage both to the visual and
auditory word centres.

Cases 66 and 67 are instances of damage to both occipital lobes. In 66,
although the wound was a glancing one, and did not perforate, it was so
near the median line, and accompanied by such severe damage to the bone,
that a symmetrical lesion of the cuneate and precuneate lobules of both
right and left sides is to be inferred. In 67 the great longitudinal
fissure was traversed by the bullet obliquely. It is of great interest
to observe that in each of these cases the lesion of the visual field
was a horizontal one and affected the lower half in place of assuming a
lateral distribution.

In all four cases the primary effect of the occipital injury was the
same--viz. absolute blindness--while the return of vision in each was of
the nature of the dawning of light. I regret that I am unable to furnish
any detail as to increase of the field of vision in the progress of the
cases, but circumstances rendered continuous observation of the patients
impossible.

In each case deafness was apparently the direct result of concussion of
th