depressed
punctured fracture, surrounded by an annular fissure,
completely encircling it, 1-1/2 inch from the opening. The
portion of brain destroyed was probably a considerable portion
of the cuneate and precuneate lobules of both sides, as well as
a portion of the first occipital convolution, and the superior
parietal lobule of the right side. There was no evidence of
injury to the superior longitudinal sinus in the way of
haemorrhage.

After the operation the patient slept better, but still
complained of headache, and when he arrived at the Base, the
flap became oedematous, and the stitch holes and also the
central part of the wound suppurated. The temperature rose to
101 deg.. The wound was therefore re-opened, and a number of
additional fragments of bone, some as deeply situated as 2
inches from the surface, were removed. Steady improvement
followed, and at the end of a further three weeks the wound was
healed, the headache had ceased, and there were no abnormal
symptoms, except that light was unpleasant to the right eye,
and the field of vision was manifestly contracted (Mr. Pooley).

A year later the man was employed as a letter-carrier. He
complains of headache at times, and on six occasions has had
'fainting fits.' He says that the latter commence with tremor,
that his legs then give way and he falls. In a quarter of an
hour he gets up, and feels no further inconvenience. Speech is
perfect, there is no deafness. The bone defect is very nearly
completely closed.

Mr. Fisher reports as follows as to the vision. There is a high
degree of hypermetropia in each eye, the R. has nearly 6.0 D
and the L. about 5.0 D. With correction he gets practically
full direct vision with each.

[Illustration: FIG. 75.--Right Visual Field, in case 66. Injury to both
occipital lobes. Field for white. Test spot 10 mm. Good artificial
light. Defect in field complicated by functional symptoms]

[Illustration: FIG. 76.--Left Visual Field, in case 66. Defect in lower
half of field]

The patient has been examined before, and has been informed
that his vision quite incapacitates him from further service.
He began by stating that he could not see on either side of
him, but only straight in front; that he is apt to collide with
people in walking, was nearly knoc