(_d_) _Retinal hæmorrhages._ Fleming, in 1902, reported 12 cases of fracture of the skull, all except one being fractures of the base, in which retinal hæmorrhages were present. All cases were associated with hæmorrhage into the subarachnoid space, and when this hæmorrhage was of a unilateral nature the retinal changes were likewise one-sided. It was also found that in 4 cases of cerebral hæmorrhage without osseous lesion retinal hæmorrhages were present in three, these three being all associated with considerable effusion into the subarachnoid space. These observations are not only of value in the general diagnosis of intracranial lesions, but are also of considerable importance in the differential diagnosis between extra- and intradural hæmorrhages. (_e_) _Hæmorrhage from the nose and mouth_ is almost invariably present in fractures of the anterior fossa, with the inference that the fracture involves the cribriform plate. The blood--derived mainly from lacerated ethmoidal vessels--escapes from the anterior nares or, passing back into the naso-pharynx, escapes by the mouth or is swallowed, to be vomited up later. =Escape of cerebro-spinal fluid.= Blandin, of the Hôtel-Dieu, drew attention to this condition in the year 1840. The fracture involves the cribriform plate of the ethmoid, and is associated with laceration of the overlying dura mater and arachnoid, and of the prolongations of those membranes along the olfactory nerves. The escape of cerebro-spinal fluid from the nose may be regarded as diagnostic of a fracture of the anterior fossa, in spite of the fact that Goucard, Malgaigne, and others describe cases in which, as the result of a severe fracture of the petrous bone (middle fossa) without laceration of the membrana tympani, the fluid escaped along the Eustachian tube to be expelled by mouth and nose. At this stage, it will be necessary to allude more fully to the general question of cerebro-spinal discharge from the nose, mouth, and ear. The symptom is an important one, though undoubtedly of far less frequent occurrence than stated in text-books. This was proved by Crandon and Wilson, who reported 27 cases in which there was a cerebro-spinal discharge out of a total number of 530 cases examined. Phelps mentions 13 in a series of 286 cases of fractured base. My experience coincides with these statements. The escape of a slightly blood-stained fluid from the ear and nose does not necessarily imply that the fluid is cerebro-spinal in nature, for it has been proved on numerous occasions that fluid may escape in considerable quantities without the existence of a basic fracture. In such cases the fluid is derived either from the membranous labyrinth (the liquor cotunnii) or from the mucous membrane lining the ear and nose, the result of great vaso-motor dilatation of aural and nasal vessels.