(115) _Entry_, immediately to the right of the fourth cervical spinous process; _exit_, at the anterior border of the left sterno-mastoid opposite the angle of the mandible. The left shoulder was depressed, the head inclined to the injured side. There was evident spinal accessory paralysis, and marked hyperaesthesia of the whole left upper extremity, most severe in the circumflex area. The hyperaesthesia gradually disappeared in a few days, and was clearly due to concussion and possibly slight contusion of the cervical nerve roots. The spinal accessory paralysis improved, so that the patient returned to the front at the end of a month: when I saw him some four months later the shoulders were held quite symmetrically. The _twelfth nerve_ was occasionally damaged in wounds of the floor of the mouth. I saw no case of permanent paralysis. _Injury to the systemic nerves._ _Cervical plexus._--Evidence of injury to the superficial branches of the cervical plexus was not rare; thus I saw cases of small occipital anaesthesia, and great occipital neuralgia, but none of motor paralysis from injury to the deeper muscular branches. I take it that the smallness of the branches, and the multiple supply possessed by many of the muscles of the neck, would both take part in rendering certain evidence of the injury of an individual motor nerve rare. _Brachial plexus._--Injury to this plexus in the neck was common; the main peculiarity observed was the partial nature of the damage inflicted. Thus injury to a single nerve, or to a complex of two or more, was far more common than one implicating the whole plexus. Again, while complete paralysis might affect one set of nerves, another might simply exhibit signs of irritation in the form of hyperaesthesia or pain. The wounds producing these injuries varied much in direction; thus some crossed the neck transversely, some were obliquely transverse, while others took a more or less vertical course. These same remarks hold good in the case of the nerves of the arm. In the upper half, especially, complex injury was not rare, while in the lower third affection of individual nerves was more common. Another important difference must be mentioned in regard to the upper and lower segments of the course of the brachial nerves; they are not only more widely distributed below, but also more fixed in position, a fact antagonistic to the escape of the nerve by displacement and liable to expose it to more severe contusion. The latter point holds good in the forearm also; here, individual injuries often occurred.