immediately beneath the skin or quite
superficially in any region, or those which, although they have produced
an exit opening, yet lie within the body. 2. Those which lie at the
bottom of an infected track, or cause secondary suppuration. 3. Those
causing pressure on important structures, particularly nerves. 4. Those
which interfere with the movements of joints when lodged in the bones or
soft tissues in close proximity, or those which lie within the articular
cavity itself. Bullets sunk in the great body cavities or in positions
difficult of access should never be interfered with. Retained bullets
sometimes give rise to unexpected surprises; thus in a man with a
retained bullet in the pelvis no steps for its removal were taken.
During the man's voyage home on a transport he had an attack of
retention of urine. As a catheter would not pass, he was placed in a
warm bath, and shortly after passed a Mauser bullet per urethram, and
thus saved himself a cystotomy.

One word may be added as to the treatment of shock when severe. Quiet in
the supine position, and the administration of a small amount of
stimulant, was usually all that was required. Hypodermic injections of
strychnine sulph. grs. 1/30 to 1/10 were useful, and in some severe
cases, especially where operations were needed, saline infusions with a
small amount of stimulant were made into the veins, either at the elbow,
or in amputation cases into one of the large veins exposed.

The treatment of haemorrhage is dealt with in Chapter IV.

The after treatment of simple wounds needs little comment, but bearing
in mind what has been said as to the definite healing of the internal
portion of the tracks, it will be obvious that in parts such as the
thigh or calf, care was needed as to not commencing active work at too
early a date. On the other hand, a too long period of absolute rest is
also to be deprecated. The best results were obtained by careful
movement and massage, commenced after the first week or ten days,
according to the appearance presented by the external wound, followed by
a gradual resumption of active movement. It was a striking fact that
some of the patients suffering from such wounds took longer to become
apparently well than many of those who had suffered visceral injuries.

FOOTNOTES:

[9] _Loc. cit._ p. 31.

[10] _Loc. cit._ p. 100.

[11] _Loc. cit._ pp. 54, 55.

[12] _Wounds in War_, p. 83. Longmans & Co. 1897.

[13] A First Field Dres