Injuries of nerves and their consequences - Reflex Sympathetic ...

LESIONS OF SPECIAL NERVES. 327
The following case also amply illustrates the subject of
wounds of the focial nerve :
Case 60.— Gunshot wound involving poriio dura; loss of
eleciric contractility in the muscles of expressio7i ; no relief
William S. Sylvester,* farmer, aged twenty-two, born in
Norway. In this country sixteen jears. Enlisted for
three years, September, 1861, Company D, 7th AVisconsin.
In good health up to date of wound. At Grettysburg,
July 1, 1863, he was shot, while standing, with a minieball,
which entered the face an inch below the outer angle
of the left It e3'e. passed backward and outward across
the external auditory meatus, apparently injuring the left
ramus of the jaw, high up, and finally emerged behind
the lower half of the mastoid process, which it fractured.
He fell instantly senseless, and reviving after a few minutes,
crawled away, and with aid reached the shelter of a
house, where he was taken prisoner. After three days
he was recaptured, and sent to the Satterlee Hospital, Philadelphia,
and thence to us, August 2, 1863. The wound
has never been painful, rarely more than sore; fragments
of the jaw^ escaped anteriorly, during the treatment, and
also portions of the mastoid process at the wound of exit.
The left side of his face swelled, and is still greatly enlarged.
The conjunctiva of the left eye was a good deal
iniiamed at first,
but is now free from inflammation, and the
sight unaltered. Early in the case a good deal of blood
escaped from his left ear, and the hciiring was noticed to
be, as it still is, rather dull. The inflammation about the
articular portion of the lower jaw
is such as to have
caused great and painful difiiculty in opening the mouth,
which is so locked that it is impossible now to ascertain
by touch, within the oral cavity, how much injur}^ has
been done to the bones. At present, August 4, the ante-
* Gunshot Wounds, etc., op. cit.