y to both
occipital lobes. Field for white. Test spot 10 mm. Good artificial
light. Defect in lower half of field]

[Illustration: FIG. 78.--Left Visual Field, in case 67]

No operation was performed there, but I heard later that the
man recovered full consciousness at the end of five days, and
at the end of a fortnight he commenced to see again.

Six weeks later he travelled to Kroonstadt, thence to
Bloemfontein, and thence to Cape Town and home to Netley. The
paralytic symptoms meanwhile steadily improved.

Seven months later his condition is as follows: Scarcely a
trace of facial paralysis. Slight power of movement of arm,
forearm, and fingers, but grip is very weak. Little power of
abduction of the shoulder or of straightening the elbow. The
latter movement is made with effort and in jerks. Sensation
over the back of the arm is somewhat lowered, and is 'furry' at
the finger tips. There is very little wasting of the muscles
noticeable.

Walks well, but with some foot-drop. Slight increase of
patellar reflex. He says that he does not walk in the street
with confidence, as he often feels as if omnibuses &c. were
coming too near him.

He is absolutely deaf in the right ear.

The openings in the skull are closed, the occipital lies about
halfway between the external auditory meatus and the external
occipital protuberance, while the parietal still affords
evidence of the earlier comminution, one fissure passing
backwards as far as the lambda, and the whole surface is lumpy
and uneven.

The track through the brain no doubt involved a considerable
extent of the outer aspect of the right occipital lobe and the
cuneate lobule. It must also have crossed the great
longitudinal fissure, and penetrated the left Rolandic region,
just above its centre, probably involving the precuneate
lobule, and a portion of the internal capsular fibres as well
as the cortex on the left side. The deafness was probably due
to concussion of the internal ear.

Mr. Fisher has kindly furnished the following note regarding
the vision. The pupils, movements, and fundi are quite healthy.
There is good direct vision R. or L. 5/5 fairly, and together
5/5. The man complains he has lost his side sight, also the
lower; he demonstrates the latter quite obviousl