_Seventh nerve._--Facial paralysis was most commonly observed in cases of wound of the mastoid process, apart from central cortical facial paralyses, of which several are quoted in the chapter on injuries of the head. All the wounds of the mastoid process were, in addition, accompanied by absolute deafness. I am sorry to be unable to give any details as to the electrical condition of the muscles in these cases, but I believe that in the great majority the paralysis was mainly the result of nerve concussion, since the perforations were clean in character and not obviously accompanied by comminution. Pressure from haemorrhage into the Fallopian canal may, of course, have been present, and in some instances, particularly those in which the bullet traversed the tympanic cavity, spicules of bone may have caused laceration. In every case, however, all the branches were equally affected; the paralysis was absolute, and in none did any improvement occur while the cases were under my observation. The following are a few illustrative examples:-- (111) Boer wounded at Belmont. _Entry_, immediately above zygoma; the bullet passed through the temporal fossa, fractured the neck of the mandible, traversed the mastoid process, and emerged at the lower margin of the hairy scalp, 1 inch from the median line. Facial paralysis was complete, and there was no improvement at the end of ten weeks. (112) Wounded at Magersfontein. _Entry_, at the posterior border of the left mastoid process, 1/2 an inch above the tip; _exit_, through the right upper lip at the junction of the middle and outer thirds. There was considerable haemorrhage from the left ear. The injury was followed by complete deafness, and facial paralysis, which showed no sign of improvement. There was complete anaesthesia over the area of distribution of the third division of the fifth nerve; this improved rapidly, and at the end of five weeks was hardly to be detected; neither at that time could any impairment of power on the part of the muscles of mastication be detected. No impairment of the sense of taste was noted. (113) _Entry_, above the anterior extremity of the zygoma, bullet retained. Primary haemorrhage from ear. Complete facial paralysis and deafness. Anaesthesia over distribution of temporal branch of temporo-malar nerve, part of supra-orbital area, auriculo-temporal nerve, and small occipital cervical nerve. The muscles of mastication acted well. Ecchymosis below the right mastoid process. (114) Wounded at Paardeberg. 300 yards. _Entry_, at the posterior border of the right mastoid process, 3/4 of an inch above the tip; _exit_, the inner third of the left upper eyelid. (Eye destroyed.) Complete right facial paralysis; deaf, on right side cannot hear tick of watch either held close or in contact. Purulent otitis media.