o months later the man began to suffer
from fits every few days. He spoke of them as fainting fits,
but they were accompanied by general twitchings.

The patient was shown to me in July by Major Woodhouse,
R.A.M.C. The strength of the right upper extremity was then
good, and he walked well. Speech was slow, but correct. The
pupils were equal, and acted normally.

The mental condition was weak, and the temper irritable. The
man had hallucinations, and was very obstinate: there was
complete deafness of the left ear. He refused surgical
treatment, but was really hardly a responsible individual.

(73) _Gutter fracture in right frontal region. Traumatic
epilepsy._--Wounded at Pieter's Hill. Gutter fracture crossing
the outer aspect of the frontal lobe, immediately above the
level of the right Sylvian fissure. The wound was perforating
at the central part, but only reached as far back as the lower
end of the ascending frontal convolution. The patient was
rendered unconscious and was removed to Mooi River. He was
there seen by Sir William MacCormac, who removed a number of
fragments of bone. The patient rapidly recovered consciousness
after the operation, but was completely hemiplegic. After a
month he suddenly found he was able to move his lower
extremity, and later the paralysis became steadily less.

On his return home the man obtained employment as a
Commissionaire, but nine months after the injury, while his
wife was helping him on with his coat one morning, he was
suddenly seized with a fit; the paralysed arm was jerked up,
and convulsions became general, a wedge needing to be inserted
to prevent the tongue suffering injury.

When admitted into the hospital, the cicatrix of the wound was
considerably depressed, and the central part was evidently
continuously attached to the surface of the brain. Pulsation
was both visible and palpable, there was little or no
tenderness on examination, and the patient did not complain of
pain.

Little trace of the left facial paralysis remained. The man
walked well, but with foot-drop. The left upper extremity was
rigid, but chiefly from the elbow downwards. The fingers were
flexed, but a slight increase of grip could be effected. No
other active movements of hand. The elbow was held flexe