Husband relates a case in the Edinburgh Infirmary in which there was a large clot over the left frontal lobes, accompanied with aphasia and right hemiplegia, with no rupture of the middle meningeal artery, or any signs of external injury. The man had just left the cells on a charge of drunkenness. The source of the hæmorrhage was not clearly made out, but it seemed to be due to the rupture of an artery in a pachy-meningitic patch. Blood may be found in the cavity of the arachnoid in the great majority of severe injuries to the head, and even in trifling cases where least expected. Rupture of the venous sinuses may take place without fracture of the skull. I have met with this in a fatality during a boxing match; a large effusion over the brain, and especially in the temperosphenoidal fossa, taking place from rupture of the left lateral sinus at the junction with the superior petrosal; there was also a vertical hæmorrhage into the pons. The effused blood may, after a time, become changed, and form a false membrane on the _parietal_ arachnoid, seldom on the _visceral_ surface. Blood cysts may even be formed, in the course of time, having all the appearances of a serous membrane. The blood may spread to parts remote from the seat of injury, and the extravasation does not always occur at the exact spot of the application of the blow, but often at a spot directly opposite. Two extravasations may be the result of one blow. Fits of passion have been advanced as a cause of apoplexy, but this cause is rare. _Fracture of the cranial_ bones may be due to counter-stroke--_contre-coup_--or to falls on the nates, &c. Fractures of the skull are divided into two groups (Körber): (1) those produced by _bilateral_ compression of the skull; and (2) those resulting from violence applied to _one side_ only. _In both groups the line of fracture runs parallel with the axis of compression._ Fissures of the base from bilateral compression of the skull are always transverse. Punctured wounds of the cranium are always dangerous, but the patient may survive many days. Dr. Bigelow, Professor of Surgery in Harvard University, U.S.A., relates a case in which an iron bar, weighing thirteen and a quarter pounds, three feet seven inches in length, and one inch thick, was driven through the head, followed by recovery, the patient only losing the use of the injured eye. Contusion and laceration of the brain may occur from injuries to the head, either at the seat of injury or by contre-coup at some other part. The contused area may exhibit local extravasation of blood, or in the diffuse form, extravasations may be multiple and also on the surface. The symptoms are those of cerebral irritation, coma, or restlessness, paralysis, tonic or clonic spasms. In slight cases recovery may follow, in others some degree of loss of mentality and paralysis may remain.