e ear on the side corresponding to the wound. Deafness of the opposite
ear was never noted.

In case 67 some general blunting of sensation was noted in the paralysed
upper extremity, and in this patient, no doubt, injury to the inferior
parietal lobule accompanied the occipital lesion.

(65) _Injury to left occipital lobe._--Wounded at Belmont. A
single transverse wound, 2 inches in length, extended across
the occipital bone, 2 inches above the level of the external
protuberance. When seen on the third day the wound was gaping
and pulped cerebral matter was found in it. The patient was
very drowsy, lying with closed eyes, and complaining of great
coronal and frontal headache. He could distinguish light and
darkness, but not persons. Total blindness immediately followed
the injury, persisting some three days, and the patient spoke
of return of sight as of the appearance of dawn. The pupils
were equal, moderately dilated and acted to light, which was
unpleasant to him. He was somewhat irritable and silent, but
apparently rational. Temperature 99 deg.. Pulse 56 full. Tongue
clean. No sickness, no difficulty in micturition.

Fifty-six hours after the injury the wound was opened up and
cleaned, and an oval fractured opening about 3/4 by 1/2 inch
was exposed 3/4 inch to the left, and 2 inches above the
occipital protuberance. The margins of the opening showed
several small fragments of lead attached to the bone. A
3/4-inch trephine was applied at the left extremity of the
opening, and it was found that about a square inch of the
internal table was comminuted and driven into the brain,
together with several small fragments of lead. On introducing
the finger, about 1-1/2 square inches of the occipital lobe
were found to be pulped, and the finger could be swept across
the tentorium. There was no sinus haemorrhage (nor did the
history suggest that haemorrhage had ever been severe). The
cavity was carefully sponged out, and the wound closed with a
drainage aperture. Little change followed in the patient's
condition, and on the sixth day he was sent to the Base
hospital.

Three weeks later the wound was firmly healed. The patient
still complained of frontal headache, and wore a shade, as the
light hurt his eyes and made them water freely. The pupils
acte