320 Proceedings of the Royal Society of Edinburgh. [Sess. 
quently both types are to be met with together. Still another series 
contains those cases in which nervous symptoms predominate. 
In a small group of two cases, 3 and 6, gassed at the same time 
(September 1915), by British gas, the chief symptom was obstinate con- 
junctivitis. This was associated with tremors. It is a striking evidence 
of the profound effect which gassing has upon the tissues of the body 
that a year after the gassing the conjunctiva should exhibit such marked 
inflammatory change. 
Nervous phenomena are exhibited by a large number of cases, sometimes 
in the form of what may be called neurasthenia, as in Cases 15 and 27. 
Headache is severe and persistent in some, e.g. 15 and 32. Tremors were 
present in Cases 3, 4, and 6. 
Sleeplessness is a nervous phenomenon observed in a series of cases 
which have come under our observation quite recently, 46, 47, 48, and 49. 
These men stated that they got scarcely a wink of sleep. The sister in 
charge confirmed this, and noticed also that when they did sleep they 
were restless, shouted, sat up, and exhibited symptoms of terror. With the 
exception of one who was gassed in September 1915, they were all gassed 
in January 1917, about the same time. 
Gastric symptoms are among the most obstinate in some cases. Two 
of these, 13 and 15, are worth recording, as they are associated with a high 
leucocyte count. 
Case 13 was gassed by British gas in September 1915. He lost 
consciousness some hours afterwards, and remained unconscious for four 
days. For several days afterwards he suffered from intense nausea and 
vomiting, and these persist, in some degree, up to the present time. He 
was sent home, and after a month returned to the Front, and remained 
there from November 1915 till July 1916. He remained fairly well until 
May, when he began to suffer from pains, particularly in the shoulder and 
chest, like a knife going through him. He was again sent home, and has 
been twice in Craigleith Hospital, with intervals at convalescent homes. 
He has constant nausea and disinclination for food, and occasionally vomits. 
The pains in the chest and limbs also persist to the present time. His blood 
shows a persistent moderate leucocytosis (15,000). His differential count 
on last examination was : — polymorphs 44 per cent., lymphocytes 46 per 
cent. There is thus an absolute increase in the polymorphs as well as in 
the lymphocytes, although it is more marked in the case of the lymphocytes 
(see Table II). 
Case 15 is a very similar case who was gassed on two separate 
occasions. First, July 30, 1916, slightly, owing to sleeping through a 
