_exit_, 2-1/2 inches from the left lumbar
spines at the level of the last rib.

As an instance of the doctrine of chances I might quote the position of
the wound in the patient who lay in the next bed. Both patients were
wounded while fighting at Almonds Nek. _Entry_, through right seventh
costal cartilage, 3/4 of an inch from the sternal margin; _exit_, 1-1/2
inch from the lumbar spines, at the level of the last right rib.

In neither of these cases did anything except the position of the
external apertures point to the infliction of visceral injury.

_General remarks as to the prognosis in abdominal injuries._ The
prognosis in each form of individual visceral injury has been already
considered, but a few points affecting these injuries as a class should
perhaps be further considered.

First, as to the influence of range on the severity of the injuries
inflicted; I am not able to confirm the greater danger of short range,
except in so far as there is no doubt that more shock attends such
injuries, and possibly some of the most severely wounded were killed
outright as a direct consequence of the greater striking force of the
bullet.

Among the cases in which but slight effects were noted, however, many
were said to have been hit within a range of 200 yards, as for instance
the two injuries quoted under the heading of wounds of the spleen.

I personally saw no cases in which explosive injuries of the solid
viscera were to be ascribed to this cause.

Secondly, as to the immediate prognosis in all abdominal injuries, the
ensurance of rest and limitation as far as possible of transport were of
the highest importance, either in the case of wound of the alimentary
canal, or in wounds of the solid viscera in which haemorrhage was a
possible result.

Thirdly, as to the later prognosis in these injuries; very few men are
fit to resume active service without a prolonged period of rest. In
spite of the insignificance of the primary symptoms, or of the
favourable course taken by the injuries, active exertion was almost
always followed for some months by the appearance of vague pains and
occasionally by indications of recurrent peritoneal symptoms, pointing
to the disturbance of quiescent haemorrhages, or of adhesions. Wounds of
the kidney are apparently those least liable to be followed by trouble.

Lastly, the prognosis was influenced in the case of many of the viscera
by coexisting injury to other organs or parts.

Fo