at the expiration of one year, but no
other change.

[15] Lieut.-Colonel Lewtas, I.M.S. See _Lancet_, 1900, vol. ii. p. 1073.

[16] _Lancet_, 1900, vol. ii. p. 1074.

[17] Sir W. MacCormac, _Lancet_, vol. i. 1900, p. 876.

CHAPTER V

INJURIES TO THE BONES OF THE LIMBS

Injuries to the bones of the limbs formed a very large proportion of the
accidents we were called upon to treat, and afforded as much interest as
any class, since they possessed many special features. I shall hope to
show, however, as in some of the other injuries, that these features
differed only in degree from those exhibited by injuries from the old
leaden bullets of larger calibre, although with few exceptions they were
of a distinctly more favourable character.

It is of considerable interest to note that, taking the fractures as a
whole, there was a somewhat striking change in their nature during the
earlier and later portions of the campaign. In the earlier stages I
think there is no doubt that punctured fractures were proportionately
more common than in the later, when comminuted fractures were much more
often seen. There was, I believe, a source of error in this opinion, as
far as I myself was concerned, in that the first cases I saw were at
Capetown and had come from Natal. There is no doubt that the punctured
fractures were earlier fit to travel, and hence a larger number of them
found their way to the Base hospitals at a period when the comminuted
fractures were still in the Field or Stationary hospitals. I do not,
however, rely on the cases seen at Capetown alone for my opinion, as
while at the front I saw the same large proportion of clean punctures in
the early engagements of the Kimberley relief force.

I am inclined to attribute the change to two reasons: first, I believe
that the use of regulation weapons was more universal in the earlier
part of the war, while later, as more men were engaged, the
Martini-Henry came more into evidence, and the Boers took more freely
to the use of sporting rifles and ammunition. Another element also in
the less clean punctures of the short and cancellous bones was probably
the less accurate and hard shooting of the Mauser rifles as they became
worn; the bullets seemed to evidence this by the comparative shallowness
of their rifle grooves, which, I take it, would mean less velocity and
accuracy in flight. This would be of importance, since the clean
puncture of cancellous bone was no doub