SHELL-SHOCK ^ | +----+-----------------------------+ | | | | | SUGGESTION | ESSENTIAL! | (AUTO-, HETERO-, MEDICAL) | (Babinski) | | | | SOMETIMES SOLE | | FACTOR? +----------------------------------+ ^ | ^ | | | | | | +------------+ | +------------+ | | | | | INTRABELLUM | | | | | FACTORS | | | | | USUALLY | EMOTION | | | SHOCK | ONE OR | | | | | BOTH | | | | | | | | | | +------------+ | +------------+ ^ | ^ -------|--------------------|---------------------------- | | +------------------------------------+ | | | SOIL | FREQUENT BUT | (ACQUIRED, ANTEBELLUM) | NON-ESSENTIAL | | +------------------------------------+ ^ | ------------------|-------------------------------------- | +-------------------------------------+ | | | TAINT | FREQUENT BUT | (HEREDITARY) | NON-ESSENTIAL | | +-------------------------------------+ The scalp showed a slight frontal bruise. The brain was extremely congested. On each side of every superficial vessel there was an ecchymosis. A number of minute punctate hemorrhages was found on the surface of the brain in connection with very small vessels. The brain substance was soft, but not markedly edematous. The cerebrospinal fluid was tinged with blood. On each side of the great sinuses of the skull there was considerable ecchymosis. This examination was made by Capt. A. Stokes, R.A.M.C., in the mobile laboratory. There were no areas of large hemorrhage anywhere in the brain substance and no smaller petechiae, except the superficial ones above noted. Microscopically Mott confirmed the pial congestion and macroscopic subpial hemorrhages described in the gross. He found besides congestion also actual hemorrhage in the vascular sheaths of the corpus callosum, internal capsule, pons and bulb. Now and then blood corpuscles were found extravasated into the nervous tissue.