VII. NOTES. A REMARKABLE CASE OF AMNESIA. It is by no means a new observation that in case of cerebral concussion the resulting unconsciousness is found sometimes to involve a complete loss of memory for a period, greater or less, before the accident ; but the fact is so curious that, pending any likely explanation, it is well to put on record thoroughly well attested instances as they happen. A psychologist of Prof. Bain's eminence has recently had the misfortune to have such a "psychologi- cal experience, of which he gives the following account : " On the 23rd October last I rode out on horseback. The horse stumbled and fell. A labourer in an adjoining fiekl saw the fall ; on running up, he found me overlaid by the horse, and dragged me out insensible. I was taken to the adjoining farm-house, and was found to have sustained various injuries, the worst being a bad dislocation of the right shoulder. The insensibility continued upwards of three hours, during which time the shoulder was set without pain or knowledge. When consciousness returned, the memory of what led to the accident was dis- covered to be completely obliterated. In fact, the loss of memory extended to a full hour previous, and it has not yet been recovered. In no other respect did the concussion leave any permanent injury to the mental faculties." Prof. Bain was found on a different road from that which he remembers he, more than an hour earlier, intended to take on his way home. He must have changed his mind ; but of the change, as of all that followed upon it till the time of the accident, he has as little recollection as of the hours he lay unconscious. It was not a very long period of unconscious- ness, nor is the lapse of memory for a single hour or so very extensive. That there may possibly be some relation between the length of the two periods in cases of the kind is suggested by the facts of another case which I have later had the opportunity of verifying with the utmost care, and which are certainly so remarkable in themselves as to deserve henceforth to rank as ' the first instance ' of their class. On the 2Vth September last year, at Belper, in Derbyshire, the Hon. F. Strutt was thrown from a dog-cart, which he had suddenly to pull aside against a pavement in order to escape collision with a cart meeting him. He was driving three other people at the time, and was by them seen to fall on his right side. What followed as he lay on the ground is uncertain ; but, however caused, the result of the accident was extensive fracture of the base of the skull, shown by copious bleeding from the right ear and from the nose. Though, externally, there was only some blackness round the left eyelid, and slight abrasion of the skin on the left side of the face, the nerves on that side were so deeply injured that, besides loss of common sensation at first, sight and hearing (of left eye and ear) have perished ; also, the hearing of the right ear has been affected. Mr. Strutt was taken up unconscious, and in such a state of collapse that for some time death was hourly expected. After some days, nourishment in liquid form began to be taken, and thenceforth his strength was maintained, but he continued unconscious. It was not till the beginning of February, after four months' interval, that he 'came to himself again, having for some days previously begun to show signs of returning sense. At a much earlier stage, some four "weeks after the accident, he was thought to be recovering conscious- ness, but he had then a serious relapse ; being afterwards moved first from
