of the cord was not absolute. As abstracts of a series of cases
are appended on page 330, it is only necessary to add a few
remarks as to any slight peculiarities which seemed directly
dependent on the mode of causation.

It may be first stated that these severe injuries were
accompanied by signs of a very high degree of shock. In fact,
the shock observed in them was more severe than in any other
small-calibre bullet injuries that I witnessed. The patients
lay still with the eyes closed, great pallor of surface,
sometimes moaning with pain, the sensorium much benumbed, or
occasionally early delirium was noted. The pulse was small,
often slow and irregular, and the respiration shallow. The
originally quiet state was often changed to one of great
restlessness of the unparalysed part of the body, with the
appearance of reaction.

The degree of primary pain varied greatly, but as a rule it was
considerable; in some cases it was excruciating in the parts
above the level of the totally destructive lesion, and commonly
of the zonal variety. A hyperaesthetic zone at the lower limit
of sensation usually existed.

In the majority of the cases pain must have depended on
meningeal haemorrhage. In one of the cases related, positive
evidence was offered as to this particular by the autopsy,
although this was made as long as six weeks after the original
injury, since no other source of pressure or irritation was
discovered. When I first saw this patient some twenty-four
hours after the injury he was moaning with pain, although a
strong and plucky man; I hastened to give him an injection of
morphia, and assured him that it would relieve his suffering:
as I left I heard him say to his neighbour: 'That is no use;
they gave me three last night, and I was no better,' and his
remark proved true.

In high dorsal and cervical injuries the temperature rose high,
in one case to 108 deg. F.; I had no opportunity, however, of
observing the temperature in any case immediately before and
after death. During the hot weather the profuse sweating of the
upper part of the body contrasted very strongly with the dry
skin of the paralysed part.

The heart's action was often particularly irregular in the
dorsal injuries, and the respiration slow and irre