f this patient would have
certainly suggested a functional explanation for its presence, had it
not been for the accompanying inequality in the axillary surface
temperatures.

In a second case (No. 67) blunting of sensation followed a definite
lesion of the inferior parietal lobule. In this instance an occipital
lesion was associated with the parietal.

(60) _Parietal gutter fracture._--Wounded at Magersfontein. A
scalp wound 3 inches in length ran transversely across the
right parietal bone at the level of the lower third of the
fissure of Rolando. A second wound of entry was found crossing
the third dorsal spine; the bullet was retained and was
palpable over the right scapula. There was left facial
paralysis, weakness and numbness of both upper extremities,
especially of the left, and some difficulty in swallowing. The
man was sent to the Base, where he arrived on the fourth day.
The symptoms had then become much more marked, consciousness
was incomplete, and articulation slow and imperfect. There was
complete left hemiplegia, and deviation of the tongue to the
right. The pulse was 40. An exploration (Mr. J. J. Day) showed
that an oval plate of the outer table of the parietal bone had
been struck off. A trephine was applied to the exposed diploe
and a crown of bone removed; considerable comminution of the
inner table had occurred, several large fragments having
perforated the dura-mater. The latter did not pulsate; it was
therefore freely incised, and many more fragments of bone and a
large quantity of blood-clot removed.

The first effect of the operation was slight, but ten days
later rapid improvement commenced, the first sign being
acceleration of the pulse, which rose to 70. On the eighteenth
day the original symptoms still remained to a diminished
extent, but a fortnight later there remained traces of the
facial weakness only, and there was little difference in the
grip of the two hands. The patient was shortly afterwards sent
home. Ten months later he returned to South Africa on active
service.

(61) _Fronto-parietal gutter fracture._--Wounded at Graspan.
_Entry_ (Mauser), 1 inch within the margin of the hairy scalp,
1/2 an inch to the left of the median line; _exit_, 3-1/2
inches posterior in same line. Complete right-sided hemiplegia.