Further Remarks on a Case of Injury of the Brain. 367 



it draws up much dirt and pieces of stone into the pump, 

 besides causing the engine to work very irregularly, in con- 

 sequence of partially loosing its load every lime the air en- 

 ters the pump. Another use of the siile pipe is, to let 

 down water into the chamber of the clack to fill it, when 

 the engine is first set to work, after the pumps have been 

 standing still, and the lower part of the barrel and chamber 

 empty. 



LIII. Further Remarks on a Case of Injury of the Bruin. 



To Mr. Tilloch. 



Sir, In the I66th number and 11 7th page of your valu- 

 able Magazine, you did me the honour to insert some notes 

 of a case of an affection of the brain, the consequence of 

 local injury to the head, that came under my care, in which I 

 particularly mentioned the sympton)s, the treatment, and the 

 favourable state in which the patient James Thomas was at 

 the tune I wrote and sent it you. A very ^hort time after 

 that he had a relapse quite as severe as the former ; and as 

 the former was published, I thought it right that the latter 

 should be published also as a supplement to it, and for 

 this reason I have laid it before you. 



James Thomas continued to get better and to recover 

 very rapidly, until the 22d of February, when, without any 

 apparent cause, he was, taken so ill as to oblige him to re- 

 tire to bed. He sent to desire 1 would see him. I did so ; 

 and when I got to the house, I found him remarkably 

 weak, so that he could scarcely move himself in any di- 

 rection, but no part of his body was paralysed : he spoke 

 with difficulty, and articulated very badly, so much so, that 

 I could not understand much of what he said : he lay moan- 

 ing in the bed, and took, or at least seemed to take, very 

 little notice of any thing or any body. If I asked him a 

 question, he would answer as well as he was able : the only 

 syn)ptom he complained of was a dull pain all over the 

 bead; he never pointed lo any particular spot, but would 

 shake his head and move his hand over the whole : the pu- 

 pils of the eves were dilated, but very readilyrcohtracted on 

 the application of a lighted candle. He ate little or no- 

 thing ; could obtain no sleep ; .was very watchful. He 

 would remain a whole day without asking for any thing, or 

 speaking to any one. He is amazingly dull and stujiid ; 

 and his wife tells iiiCj his bowels are confined and his stools 

 A a 4 very 



