Gage to recover. The head had been dressed by myself three times every day; ice water kept on the head and face; the discharges carefully cleaned off, externally, while the attendants washed the mouth and fauces as often as necessary, with water and disinfecting solutions. The opening in the top of the head was always carefully covered with oiled silk underneath the wet compresses. To-day he appears stronger and more rational than before; calls for food.
Sept. 24th, 9, A.M. I find in my notes, taken at the time, that he has a pulse at 84; vision with right eye, and hearing with both ears, normal; bowels confined; can tell the day of the week, and time of day; remembers persons who have visited him and incidents which have transpired since his injury. This improvement, however, was of short duration, though the discharge from the wounds had abated. I learned that in the night following he became stupid, did not speak unless aroused, and then only with difficulty; the integuments between the lower edge of the fracture in frontal bone and left nasal protuberance, swollen, hot and red, something like an erysipelatous blush. Pulse 96, soft. Failing strength. Is supported with food and stimulants. During the three succeeding days the coma deepened; the globe of the left eye became more protuberant, with fungus pushing out rapidly from the internal canthus. This fungus first made its appearance on the 19th, six days after the injury; also large fungi pushing up rapidly from the wounded brain, and coming out at the opening in the top of the head. On the 27th, the swelling upon the forehead fluctuated. The exhalations from the mouth and head horribly fætid. Pulse 84. Comatose, but will answer in monosyllables when aroused. Will not take nourishment unless strongly urged. Calls for nothing. Surface and extremities incline to be cool. Discharge from the wound scanty, its exit being interfered with by the fungi. The friends and attendants are in hourly expectancy2
