toxic
influences, or to be the seat of ascending changes (e.g. ulnar,
musculo-spiral, and external popliteal), were those most often affected
by secondary neuritis. Many of the most severe cases I saw were in the
musculo-spiral nerve.

_Scar implication._--The signs of this most commonly commenced with
neuralgia, or painful sensations when such movements were made as to put
the cicatrix on the stretch. Although such neuralgia might not be
constant, it was often observed to be troublesome when the patients were
exposed to cold in sleeping out at night, or to extra fatigue, as in
long marches. The results in many cases stopped at this point, but the
size and wide distribution of certain nerves rendered even such slight
symptoms of importance; while in others well-marked signs of neuritis
declared themselves, such as glossy skin, pain, muscular wasting, and
paralysis.

_Ascending neuritis._--In a few cases I observed very remarkable
instances of ascending neuritis, after comparatively slight wounds. I
will quote three of these as illustrations and make no further remarks
as to the symptoms. It will be observed that one is a case of ulnar,
both the others of external popliteal, neuritis:--

(108) _Ulnar nerve: secondary ascending neuritis._--Boer
wounded at Elandslaagte. Wound of hand, implicating anterior
two-thirds of third metacarpal bone. This bone, together with
the middle finger, was removed, and healing took place by
granulation slowly.

The resulting gap allowed considerable overlapping of the
fingers, and shortening of the corresponding digit; the index
finger also became flexed as a result of destruction of the
extensor tendons. Three months later the man was still in
hospital in consequence of the tardiness with which the wound
had healed: at this time pain was noted, which became very
severe in the whole course of the ulnar nerve; superficial
hyperaesthesia and deep muscular tenderness developed, but no
wasting. Several crops of herpetic vesicles also developed over
the distribution of the radial nerve in the hand. This pain was
followed by spastic contracture, first of the ulnar fingers and
later of the wrist and elbow, which could only be straightened
by the application of considerable force. The limb was,
therefore, kept straight by the application of a splint; and
warm baths, and a blister applied over