Here, then, paralysis followed a shell explosion while the subject was lying down. No contusion therefore was possible. According to Babinski, we are dealing probably with a hematomyelia, the result of shell explosion. Struck by missile in back; unconsciousness; no wound: Hysterical paraplegia? HERPES and SEGMENTARY Hyperalgesia suggest radicular and spinal injury. Recovery. =Case 210.= (ELLIOT, December, 1914.) November 1, 1914, a sergeant in the 20th Hussars, with other dismounted cavalrymen, was chasing Germans with a bayonet, over turnip fields pitted by shells. Several hours later, he found himself in a house in a nearby village, to which he had been carried unconscious. Probably he had been struck by some missile in the back, as the bottom of his haversack had been torn off. His face was blackened with smoke, and his clothes were muddy. He had no wound. His left arm was weak and his legs powerless and numb. The passing of water was painful, but there was no blood in the water and no hemoptysis. Five days later, he was examined at a base hospital and found to be paralyzed and numb in the legs. The knee-jerk and ankle-jerk were retained upon the right side only. Pain occurred on passive movements of the legs, which were flaccid; there was a hyperalgesia about Poupart’s ligament, more marked on the left side. Lower abdominal reflexes were weak on the left side; pain in lower abdomen with bladder full and at outset of micturition. Pain and paresis also affected the left arm, but there was no numbness. Pain on pressure over lumbar and cervical vertebral spines. There was no evidence of bruising. The physicians were inclined to regard the phenomena as hysterical. Three days later, the arm movements became much freer, and after another three days, the arm movements were fairly powerful, and the legs much stronger, although the patient could not yet stand or walk. He still had pain if his bladder was full. CHART 9 CAUSES OF SHELL-SHOCK HEAD INJURY ATMOSPHERIC CONCUSSION MENTAL STRAIN NON-NERVOUS TRAUMA NEUROPATHIC HEREDITY After Ballard As against the diagnosis of hysteria, three herpetic clusters appeared on the skin of the left thigh, from three to six inches above the knee. Elliot regards it as certain that the posterior root ganglia were injured. He regards the case as one of injury to the spinal nerve roots. The hyperalgesia about the body of course suggested damage to the spinal cord. According to Elliot, therefore, this case is one of organic disease; whether of the roots or of the cord was uncertain. At any rate the cases of this type, though not functional, recovered. Mine-explosion; burial; labyrinthine lesions and head bruises, more marked on left side: Focal canities (WHITE HAIR developing OVERNIGHT) on left side. =Case 211.= (LEBAR, June, 1915.)