That true “shock,” (_ébranlement_ of French writers,) as distinguished from shock resulting from mental depression after unusual excitement, or the effects of groundless alarm on the part of a patient, is a phenomenon the essential relations of which are connected with vital force, and with that endowment of the organization only, may be judged from observation of cases in which the direct result of the wound is inevitably fatal, including many where no physical effects on neighboring parts from concussion could possibly be produced. In such injuries the “shock” remains, from the time of first production of the fatal impression till life is extinguished. And the practical experience of every army surgeon teaches him that where a ball has entered the body, though its course be not otherwise indicated, the continuance of shock is a sufficient evidence that some organ essential to life has been implicated in the injury. That the shock of a severe gunshot wound may be complicated with other symptoms, or that some of its own symptoms may be exaggerated from other causes,—hopes disappointed, the approach of death, and all the attendant mental emotions,—scarcely affects the question at issue; for its existence, independent of these complications, in all such cases is undoubted. =Primary hemorrhage.=—Primary hemorrhage of a serious nature from gunshot wounds does not often come within the sphere of the surgeon’s observation. If hemorrhage occur from one of the main arteries, it probably proves rapidly fatal; and surgeons, after an action, are usually too much occupied with the urgent necessities of the living wounded to spare time for examining the wounds of the dead, who are mostly buried on the field where they fall. Thus most surgeons speak of primary hemorrhage being exceedingly rare, more rare, perhaps, than it actually is. M. Baudens, referring to his service in Algeria, has remarked that he has often found on the field of battle wounded soldiers who had died of primary hemorrhage.