An accumulation of interesting specimens showing various types of lesions after spontaneous rupture of cerebral vessels has prompted the writing of this report. The purpose of the paper is to describe four types of spontaneous hemorrhages classified according to the clinical and postmortem observations in twenty cases and to outline the surgical treatment of the types that can be benefited by lumbar puncture or operation. Cases of spontaneous bleeding in cerebral tumors are not included in these types. The great problem, of course, lies in the correct diagnosis, so that the occasional surgical cases may be picked from the large group of apoplexies. The selection of cases can be facilitated by dividing them into types based on the clinical findings so as to be of service at the bedside. Interest in the symptomatology of cerebral bleeding has been gradually increasing since the publication of papers by Symonds1and Cushing