happened to see complete
unconsciousness. The slight evidence of compression was perhaps
explained in most cases by the large bony defect in the skull, which
acted as a kind of safety-valve. Again the firm nature of the
cicatricial tissue which formed at the periphery of the injury and
extended up to the skull and there formed a more or less firm
attachment, also preserved the actual brain tissue to some degree from
either pressure or direct irritation. After evacuation of the pus, the
usual difficulty was experienced in ensuring free drainage, and
definitive healing and closure of the cavities was very slow. The
following two cases will illustrate the character of the cases of
cerebral abscess we met with:--

(70) _Fronto-parietal abscess._--Wounded at Magersfontein
(Mauser). _Entry_, 1-3/4 inch above the line from the lower
margin of the orbit to the external auditory meatus, and 1-3/4
inch behind the external angular process; _exit_, a little
posterior to the left parietal eminence. There was right
hemiplegia. The wounds were explored, and a large number of
fragments of bone and pulped brain were removed, especially
from the anterior wound. No great improvement followed, and the
patient was sent to the Base. At this time there was a large
hernia cerebri at the anterior wound which was suppurating.

A further operation was here performed (Mr. J. J. Day). The
hernia cerebri was removed, also several fragments of bone
which were found deeply imbedded in the brain. The patient then
improved, but a month later his temperature rose, and on
exploration an abscess was discovered in the frontal lobe and
drained.

Subsequently the patient suffered with Jacksonian seizures,
sometimes starting spontaneously, sometimes following
interference with the wound. The convulsions commenced in the
muscles of the face, and the twitchings then became general.
Meanwhile the right upper extremity remained weak, although the
fist could be clenched, and all movements of the limb made in
some degree.

Some difficulty was experienced in maintaining a free exit for
the pus, which was however overcome by the use of a silver
tube. All twitchings ceased about a month after the opening of
the abscess, the man improved steadily, and he left for England
fifteen weeks after the reception of the injury, walking