ly at the moment of impact of the bullet.

At the post-mortem examinations of injuries of this nature it was common
to find one to four segments of the spinal cord completely disorganised.
At the end of some five weeks, the common duration of life, the
structure of the cord was represented by a semi-diffluent yellowish
material, the consistence of which was so deficient in firmness as to
allow the partial collapse of the membranes covering the affected
portion, so as to exhibit a definite narrowing when the whole was held
up (see fig. 79). In such cases traces of extra- or intra-dural
haemorrhage sometimes still persisted.

_Haemorrhage._--This occurred as surface extravasation and in the form of
parenchymatous haemorrhages. I saw the former both in the extra-dural and
peri-pial forms, but never in sufficient quantity to exert a degree of
pressure calculated to produce symptoms of total transverse lesion. Here
again, however, it is difficult to speak with confidence since the
conditions which regulate the tension within the normal spinal canal are
so complicated and liable to variation, that it is very difficult to
estimate the effect of any given haemorrhage discovered.

My friend Mr. R. H. Mills-Roberts described to me one fatal case under
his care in the Welsh Hospital in which extra-dural haemorrhage was so
abundant as, in his opinion, to have taken a prominent part in the
production of the paralytic symptoms.

Examples of both extra- and intra-dural (peri-pial) haemorrhage are
afforded by cases 99, 102, and 103; in none was it large in amount or
widely distributed. The condition was probably also frequently
associated in varying degree with that to be immediately described
below.

_Intra-medullary haemorrhage_ (_haemato-myelia_).--The importance of this
condition is lessened in small-calibre bullet injuries by the fact
already alluded to, that it is almost invariably accompanied by
concussion changes. In one instance in which death took place at the end
of eight days, partly as the result of concurrent injury, in a man in
whom signs of total transverse lesion of the cord were present, the
substance of the cord was found to be closely scattered over with
haemorrhages of various sizes and extending for a longitudinal area of
some three inches.

As to the frequency with which haemorrhage into the substance of the cord
occurred, I regret to be unable to give an opinion. In the late
post-mortem examinations I wit