From this time until the 3d of October, he lay in a semi-comatose state, seldom speaking unless spoken to, and then answering only in monosyllables. During this period, fungi started from the brain, and increased rapidly from the orbit. To these was applied nitrate of silver cryst., and cold to the head generally. The dressings were renewed three times in every twenty-four hours; and in addition to this, laxatives, combined with an occasional dose of calomel, constituted the treatment. The pulse varied from 70 to 96—generally very soft. During this time an abscess formed under the frontalis muscle, which was opened on the 27th, and has been very difficult to heal. Discharged nearly [8 ounces (∼240 ml)] at the time it was punctured.
Oct. 5th and 6th.—Patient improving. Discharge from the wound a sinus, laudable pus. Calls for his pants and wishes to get out of bed, though he is unable to raise his head from the pillow.
7th.—Has succeeded in raising himself up, and took one step to his chair, and sat about five minutes.
11th.—Pulse 72. Intellectual faculties brightening. When I asked him how long since he was injured, he replied, "four weeks this afternoon, at 4½ o'clock." Relates the manner in which it occurred, and how he came to the house. He keeps the day of the week and time of day, in his mind. Says he knows more than half of those who inquire after him. Does not estimate size or money accurately, though he has memory as perfect as ever. He would not take $1000 for a few pebbles which he took from an ancient river bed where he was at work. The fungus is giving way under the use of the crys. nitrate of silver. During all of this time there has been a discharge of pus into the fauces, a part of which passed into the stomach, the remainder being ejected from the mouth.
20th.—Improving. Gets out and into bed with but little assistance. Sits up thirty minutes twice in twenty-four hours. Is very childish; wishes to go home to Lebanon, N.H. The wound in the scalp is healing rapidly.
Nov. 8th.—Improving in every particular, and sits up most of the time during the day. Appetite good, though he is still kept upon a low diet. Pulse 65. Sleeps well, and says he has no pain in the head. Food digests easily, bowels regular, and nutrition is going on well. The sinus under the frontalis muscle has nearly healed. He walks up and down stairs, and about the house, into the piazza, and I am informed this evening that he has been in the street to-day.—I leave him for a week, with strict injunctions to avoid excitement and exposure.
15th.—I learn, on inquiry, that Gage has been in the street every day except Sunday, during my absence. His desire to be out and to go home to Lebanon has been uncontrollable by his friends, and he has been making arrangements to that effect. Yesterday he walked half a mile, and purchased some small articles at the store. The atmosphere was cold and damp, the ground wet, and he went without an overcoat, and with thin boots. He got wet feet and a chill. I find him in bed, depressed and very irritable. Hot and dry skin; thirst; tongue coated; pulse
