The treatment of fractures . the opera-tion the following examinationwas made : The speech is thick,slow, and with effort. The facial muscles of the left side arestiff and slightly drawn ; theydo not move so well as on theright side. The left nasolabial fold is more accentuated than the left eyebrow is lower than the right. The patient thinks that shecan hear better with the right ear than with the left. The right handgets cold and does not look natural. The right forefinger is oftenwhiter than the other fingers of the right hand. It is difficult to pickup needles or pins with the fi
The treatment of fractures . the opera-tion the following examinationwas made : The speech is thick,slow, and with effort. The facial muscles of the left side arestiff and slightly drawn ; theydo not move so well as on theright side. The left nasolabial fold is more accentuated than the left eyebrow is lower than the right. The patient thinks that shecan hear better with the right ear than with the left. The right handgets cold and does not look natural. The right forefinger is oftenwhiter than the other fingers of the right hand. It is difficult to pickup needles or pins with the fingers of the right hand. There is noincrease in the wrist-jerks. The knee-jerk is slightly greater on theright side than on the left. The patient says she is enjoying excellent health, eats and sleepswell, and is out of doors much of the time. She is taking bromidof potassium regularly once a day in small doses. About once amonth she has a fainting or weak spell. These attacks are grow-ing less pronounced and less Fig. 24.—Case I. Line of incision shown. ILLUSTRATIVE CASES 41 This case illustrates the important fact that after a severe headinjury with almost no external visible sign, the patient should be keptunder very careful observation through the hours immediately succeed-ing the accident. Relative symptoms are of far greater importancein head injuries than isolated observations. Bleeding from the ear asa symptom in head injuries does not necessarily imply fracture of thepetrous portion of the temporal bone. Rupture of the tympanummay cause bleeding from the ear. There was no fracture of the skulldetected after careful examination in this case. The interval of consciousness in this case was a somewhat shortand hazy one. Immediately after the accident the woman was dazed,and at no time was she herself mentally. It is to be remembered inthis connection that the intervalof clear consciousness may be somasked by the symptoms of con-cussion as to be completely over
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