s of
Belgium were almost invariably contaminated with putrefactive organisms,
and gaseous gangrene and tetanus were common complications. It has been
found also that wounds inflicted in naval engagements present different
characters from those sustained on land. Many other factors, such as the
physical and mental condition of the men, the facilities for affording
first aid, and the transport arrangements, also play a part in
determining the nature and condition of the wounds that have to be dealt
with by military surgeons.

Whatever the nature of the weapon concerned, the wound is of the
_punctured, contused, and lacerated_ variety. Its severity depends on
the size, shape, and velocity of the missile, the range at which the
weapon is discharged, and the part of the body struck.

Shock is a prominent feature, but its degree, as well as the time of its
onset, varies with the extent and seat of the injury, and with the
mental state of the patient when wounded. We have observed pronounced
shock in children after being shot even when no serious injury was
sustained. At the moment of injury the patient experiences a sensation
which is variously described as being like the lash of a whip, a blow
with a stick, or an electric shock. There is not much pain at first, but
later it may become severe, and is usually associated with intense
thirst, especially when much blood has been lost.

In all forms of wounds sustained in warfare, septic infection
constitutes the main risk, particularly that resulting from
streptococci. The presence of anaerobic organisms introduces the
additional danger of gaseous forms of gangrene.

The earlier the wound is disinfected the greater is the possibility of
diminishing this risk. If cleansing is carried out within the first six
hours the chance of eliminating sepsis is good; with every succeeding
six hours it diminishes, until after twenty-four hours it is seldom
possible to do more than mitigate sepsis. (J. T. Morrison.)

The presence of a metallic foreign body having been determined and its
position localised by means of the X-rays, all devitalised and
contaminated tissue is excised, the foreign material, _e.g._, a missile,
fragments of clothing, gravel and blood-clot, removed, the wound
purified with antiseptics and closed or drained according to
circumstances.

#Pistol-shot Wounds.#--Wounds inflicted by pistols, revolvers, and small
air-guns are of frequent occurrence in civil practice, th