ns
of irritation; in others the paralysis was of such a degree as to lead
to the inference that a complete regeneration of the existing nerve
would be necessary prior to the restitution of functional capacity.

In a certain proportion of the injuries the development of a distinct
fusiform swelling in the course of the nerve pointed to the existence of
considerable tissue damage, while in others this was evidenced
clinically by early signs of neuritis.

III. _Division or laceration._--The varying mechanical conditions
affecting the last class of injury play a similar role here. Thus the
degree of laceration depends on the direction of the wound track, and as
all lacerations are accompanied by contusion, the relative velocity
retained by the travelling bullet assumes the same importance.

I saw every degree of injury to the trunks, from notching to complete
solution of continuity, and in some cases destruction and disappearance
of pieces from one to two or more inches in length. Such lesions as the
latter were most common in the forearm. In this segment of the limbs
tracks of varying degrees of longitudinal obliquity are readily
produced, whether the patient be in the upright or prone position,
since the upper extremities are commonly in forward action whichever
position is assumed.

The most peculiar form of injury consisted in perforation of the trunk
without gross destruction of its fibres, and without in many cases
prolonged or permanent loss of functional capacity. I cannot speak with
any confidence as to the comparative frequency of occurrence of this
form of injury, but judging by the analogous perforations of the
vessels, it is probably not uncommon in trunks large enough to allow of
its production. The trunk nerves of the arm, and the great sciatic
nerve, were probably the most frequent seats of such wounds. As,
however, a very short experience of the futility of early interference
in the case of nerve lesions warned me against exploration before a date
at which observations of this nature were unsatisfactory, I gained less
experience on this point than I could have wished.

In the case of completely divided nerves the development of a bulbous
enlargement on the proximal end was constant, and very marked in degree.
I saw few cases in which primary effects could be certainly referred to
pressure or laceration by bone spicules, excepting in some fractures of
the humerus, and perhaps some injuries of the sevent