The strabismus returned. His eye became dull and semi-glazed, nd his pupils were widely dilated and little affected by iiii'ht. By the eighteenth day these untoward symptoms had in a great measure abated. He was sensible and 1XJI TUT. -J1-").d for implicated. His pupils still somewhat dilated, but active. Then- was also somw natural, and undisturbed. Except the temp-ran irritation caused by some spiculse of bone, he went mi improving from tliat time. Attention to his of his I allowing a free exit be.-ecrcted j)us, comprised all tlie treatment followed in t; If his bowels were tor a day unrelieved, the bad symptoms immediately reappeared.
I examined him previous to his going to England, and at that period he was in every way recovered. The head wound was entirely closed, but a depression to the nt of about three-fourths of an inch existed over the site of the injury, and the pulsations of the brain quite- percept! I learn from 1 K-puty- Inspector Taylor, that K at Fort Pitt, on the L)s th May, 1856, on account of "general loss of sensibility and motion, partial in the upper, but most complete in the lower extremiti ITU in hospital at Chatham, from 2:>rd March to.June, ISOU, his state I: " the head formed two ftidefl "I" a triangle, and is about two and a half inches in length on the right i much longeron the left.
It is f an intermitt- MI; lower extremities, with IMG WAK'. exception of l)oing able to draw them up and stretch them out in lr<l. lias not lost much flesh, and his general health and functions good." He thus appears to have relapsed after leaving the Crimea, as the marked paralysis he had at Chatham did not exist when he left cam]). The intermittent headaches, spoken of in this case, are among the most troublesome sequences of injuries of the head. A careful regulation of the bowels and diet, with blisters to the nape, and morphia, appeared to me the best remedies.
It is a remarkable feature in the progress of head cases, how often the setting up of subacute inflammation shows itself by an aggravation of the leading symptom whatever that may be which had existed before: the headache, palsy, or epileptiform fits. This was clearly defined in several cases. The following is an example of a severe injury of the fore-part of the head, caused by a piece of stone. A French chasseur-a-pied was struck on the centre of the forehead, above the root of the nose, by a piece of stone about the size of a walnut, knocked up by a shell. The stone completely buried itself, and required some skill to extract it. Pieces of bone, comprising nearly the whole ethmoid, were discharged, and a large hole in the frontal bone resulted.
Three days afterwards, transient, but easily-allayed head symptoms appeared, and he made a most excellent recovery, with a fistulous opening, however, remaining. The interest attaching to this case arose from the fact that the inner table of the skull was not fractured, and from the almost total absence of any head symptoms. It is well known that balls may perforate the outer OF Tin: iir.Ah. of the skull mi tlu 1 forehead, without injuring the r. Of this the above may be i an example; although a stone, and not a leaden ball, was the missile. cases occurred in the Crimea of another wound id which is curious, such as are caused by balls passing from side to side of the head below the level of the brain, but destroying one or both eyes.
At Inkerman a French soldier was struck by a ball the upper part of the left parietal bone. A comminuted fracture was caused; the bone to the extent of a square inch being so broken and detached, as to be 'Ycd at the first dressing. The dura mater was tlv injured, and a small spiculum, which had been driven into the 1 train, was withdrawn. He remained speechless for about a week, then articulated hesitatingly, and finally, about six weeks from the receipt of the id. completely recovered his power of speech. The curious thing in this case was, that perfect ana-sthesia of the thumb and two first fingers of the right hand existed from the moment of injury, wit limit any loss of motion, and that this sl< ppeaivd as the wound healed, and he recovered.