plete anaesthesia over the area of distribution of
the third division of the fifth nerve; this improved rapidly,
and at the end of five weeks was hardly to be detected; neither
at that time could any impairment of power on the part of the
muscles of mastication be detected. No impairment of the sense
of taste was noted.
(113) _Entry_, above the anterior extremity of the zygoma,
bullet retained. Primary haemorrhage from ear. Complete facial
paralysis and deafness. Anaesthesia over distribution of
temporal branch of temporo-malar nerve, part of supra-orbital
area, auriculo-temporal nerve, and small occipital cervical
nerve. The muscles of mastication acted well. Ecchymosis below
the right mastoid process.
(114) Wounded at Paardeberg. 300 yards. _Entry_, at the
posterior border of the right mastoid process, 3/4 of an inch
above the tip; _exit_, the inner third of the left upper
eyelid. (Eye destroyed.) Complete right facial paralysis; deaf,
on right side cannot hear tick of watch either held close or in
contact. Purulent otitis media.
In this place I might mention two other cases of lesion of the seventh
nerve secondary to wound of peripheral branches. In one a patient was
struck by several fragments of lead from a bullet which broke up against
a neighbouring stone. These for the most part lodged in the skin over
the left orbicularis muscle, but one also lodged in the conjunctiva and
was removed. Some ten days later the patient complained that he could
not lift the upper lid. The levator palpebrae was normal, but spasm of
the orbicularis held the eye firmly closed. The condition did not
improve, and the patient was invalided home. He recovered later.
In another patient a bullet entered above the right zygoma and traversed
the orbits, without wounding the globes. At the time no want of power of
the muscles of the face was noted, but a year later there was evident
weakness of the whole of the muscles of the right side of the face, with
loss of symmetry.
In the former case the functional element was strong, but in both an
ascending neuritis was probably present.
_Tenth nerve._--The pneumogastric was implicated in many wounds of the
neck. I never observed an uncomplicated case, but laryngeal paralysis
was temporarily present in two of the cases of cervical aneurism in
which the wound crossed above the level of origin of the r
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