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[Page 7]
extradural haemorrhage, owing to the absence of signs or symptoms of intracranial pressure ie normal pulse, no loss of consciousness, equal pupils etc. I came to the conclusion therefore that all the signs were due to a local concussion effect, possibly with some microscopical con intra-cortical haemorrhages & decided that nothing would be gained by trephining. I simply sutured the scalp wound.
The next day he was very much better. [Hemiplegin?] had improved ie. he could move R. leg and R. arm, but unable to extend wrist (due I thought to a lesion either concussion or anatomical division of the musculo spinal nerve from the bullet wound). He could say a few simple words. We kept him here about 18 days, & he steadily improved the whole time. The musculo spinal paralysis disappeared about the 5th day, so the lesion could only have been due to a concussion of the nerve.