Some of the French writers on the neurology of the war, as illustrated in the records collected by Dr. Southard, have brought to our attention distinctions which they draw between _états commotionnels_ and _états émotionnels_--happy terms, and yet not sufficient in their invention or in the explanations which accompany them, fully to satisfy the requirements of the facts presented. These writers seem to think of the commotional states as denoting some real disease or condition of the brain, and yet one which is really curable and reversible. They explicitly tell us, however, that these commotions fall short of being _lésionnel_. After all, is this not somewhat obscure? Is it not something of a return to the period of “railway spine” when one of the comparisons sometimes made was that the injury suffered by the nervous tissues produced in them a state comparable to that of a magnet which had been subjected to a severe blow? At any rate, in commotion thus discussed the nervous structures are supposed to sustain some real injury of a physiochemical character, whereas in the emotional states the neurones are, as Southard puts it, affected somewhat after the manner of normal emotional functioning, except perhaps that they are called upon to deliver an excessive stream of impulses. The latter would be classed among the psychopathic, the former among the physiopathic affections, and yet the distinction between the two is not always quite clear. In not a few instances of Shell-shock--although these are not numerous, so far as records have been obtained--actual structural lesions have been recorded even in cases in which no direct external injury of a material kind was experienced as a result of the explosion of shells. In others the evidences of external injury were relatively unimportant. Various lesions, in some cases recognizable even by the naked eye, were present. Mott, for example, found not only minute hemorrhages, but in one instance a bulbar extravasation of moderate massiveness, the patient not showing external signs of injury. Cases are also recorded of hematomyelia; others with edematous or necrotic areas in the cord; and still others with lesions of the ependyma or even with splitting of the spinal canal, reminding one of the classical experiments of Duret on cerebral and cerebrospinal traumatisms. It has been argued that too much stress should not be laid on a few cases of this sort--but are they as few as they seem to be? The fact is that necropsical opportunities are not often afforded. May not such scattered lesions often be present without resulting in death or even in long continued disturbance? There is no essential reason why minute hemorrhages into the brain and spinal cord, and especially into their membranes, may not undergo rapid absorption or even remain unchanged for some time without dire results.