Mr. Shaw on the Facial Nerves. 129 



I shall now describe a case which I suspect is a very uncom- 

 mon one, but it will more clearly shew the distinction between 

 the two cases already related. 



The history of the first part of the case was very care- 

 fully taken by my friend Mr. Csesar Hawkins ; it will not 

 however be necessary in the present inquiry to detail the 

 whole of the symptoms. The leading circumstances were the 

 following : — 



Phipps, a bricklayer, now living in Brunswick Mews, Bryan- 

 stone-square, on the 1st of September, fell from a scaffold 

 thirty feet high. His right clavicle was broken, his right loin 

 and hip were much bruised, and he received a severe contusion 

 on the head, the marks of which were particularly observable in 

 a puffiness behind the right ear, and in bleeding from the same 

 ear and from the nose. 



He was in a state of stupor when brought into the hospital, 

 but from this, he recovered in the course of the day. For 

 the two or three first days, he appeared to suffer, only from 

 the effects of concussio7i, never having any of those symptoms 

 which are generally attributed to compression. On the fourth 

 day it was observed, that the angle of the mouth was drawn 

 rather to one side, and there was also a degree of inequality in 

 the contraction of the pupils. 



On the sixth day it was remarked, that while he was asleep, 

 the right eye was more than half open, while the left was closed. 



The notes of the case are very full, up to the 24th of Sept., 

 and shew that the patient had, during the interval, gone 

 through the common series of symptoms which accompany 

 that slight inflammation of the brain, which is often the con- 

 sequence of concussion. 



On the first of October, he was made an out-patient, his 

 face being, at this time, very much distorted. On the 17th 

 of October, I visited him at his own house, and with the as- 

 sistance of Mr. Hawkins, examined particularly into all his 

 symptoms. 



The general appearance of his face was that of a man who 



Vol. XIII. K 



