greater force from the bullet)
improved more slowly, becoming normal only at the end of three
weeks.

I observed an identical case of injury to the cervical roots, and many
similar instances in injuries of the nerve trunks of the limbs in which
the course was exactly parallel. In the more severe, pain was often
added to hyperaesthesia.

In the most severe cases the signs corresponded in all particulars,
except in the early entire loss of reaction of the muscles to
electricity, with those of complete section. Loss of sensation and
motion was immediate, complete, and prolonged, the limbs being lowered
in temperature, flaccid, and powerless. General systemic shock was also
severe. In the case either of plexus or multiple contusions, or where
the injury was more local, correspondingly complete signs were present
in the area supplied by the affected nerves.

In the cases in which the contusion was not of extreme degree,
hyperaesthesia often developed as a later sign, and was probably due to
the irritation of haemorrhage, when the sensory portion of the nerve
began to regain functional capacity. The date of appearance of the
hyperaesthesia varied from a few days to a week or later. It might then
persist for weeks or many months.

In a few instances large blebs rose on the back of the hand, or patches
of vesicles appeared over the terminal distribution of the nerve,
pointing to early trophic changes.

The period of recovery varied greatly; in some instances of very
complete paralysis, function was regained and became apparently normal
at the end of three or four weeks; in others, even after severe wasting
of muscles for weeks, rapid improvement occurred often suddenly, while
in some there was no apparent recovery at the end of months. In cases of
long-deferred improvement, wasting of the muscles became a very
prominent feature; but this without complete loss of reaction of the
muscles to electrical stimulation.

Recovery of sensation usually preceded by some time that of motion, the
former often reappearing in some degree at an early date, and, even if
very modified in character, it formed a most useful and valuable aid
both in diagnosis and prognosis.

When in a position allowing of direct examination, the contused portion
of the nerve sometimes developed a palpable fusiform thickening,
manipulation of which might give rise to formication in the area of
distribution--a favourable prognostic sign.

Many of