CASE 1080. — J. Gager, Co. M, 14th New York Heavy Artillery, aged 42 years, wounded at Spottsylvania, May 12, 1864. The ball entered the left posterior neck one and three-quarter inches from the spine of the third cervical vertebra, and was cut out immediately behind and below the left ear, about two and a half inches below meatus and a quarter of an inch behind the jaw. Its track is unknown, except that it injured the ear and paralyzed the portio dura of the seventh nerve and splintered the edge of the ramus of the jaw. His head, at the time he was shot, was thrown forward and downward. He fell, conscious, bleeding freely from the ear only. After two minutes he arose and walked away, the blood still spouting out from the ear, until it was checked by a bandage over that organ. He had no pain until the next day, when he had the usual inflammatory pains. His eyesight is said to have become affected on the second day, when there was, according to his account, a distinct difference against the left eye. Things appeared hazy to the left eye. This remains the same. The paralysis of the muscles was immediate, and his speech was made difficult. This seemed to him to come from a defect in the tongue and lips. Hearing was lost at once in the left ear. Present state, June 8, 1864: The pains in the face and the swelling, which was never great, are now better. The wounds are open but healing. The nutrition is unaltered. The lines of the face are lost, the tip of the nose and the lower mobile portions of the face are drawn to the right. The left eyebrow has fallen a little. The tears run over the edge of the lid. The tongue is perfectly movable and under entire control of the will. Speech perfect, except a slight difficulty in articulating the gutturals, and still more as to the labials. Special Senses: The left eye sees only one-third as well as the right. Hearing is lost in the left ear. On washing out the pus a mass of granulations was seen at the bottom of the ear. Possibly the bony meatus may have been fractured by the ball, but no bone escaped except pieces of the jaw, which came out with the ball. Taste: There seems to be no marked loss of gustation. Taste is dulled a little on the left side. Tactility is equally good on the two sides, both in the tongue and face. June 20th, the sight is becoming worse. Dr. Dyer is of opinion that it was affected before he received his wound. Induced electric currents give rise to slight movement in the left eyelid and the elevator of the angle of the mouth. A rapid recovery was predicted, and in fact, within three days later voluntary power returned in the orbicular muscle of the eye. By July 27th, every motion had been re-acquired.
Gunshot wounds, and other injuries of nerves. By S. Weir Mitchell, M. D., George R. Morehouse, M. D. and William W. Keen; publisher: Philadelphia, J. B. Lippincott & co., 1864.