houlder-joint._--Wounds of this articulation were by no means common.
This depended, I think, on two points in the architecture of the joint:
first, a bullet to enter the front of the cavity and traverse the joint
needed to come with great exactitude from the immediate front; secondly,
wounds received from a purely lateral direction calculated to pierce the
head of the humerus and the glenoid cavity were naturally of very rare
occurrence. Wounds of the prominent tip of the shoulder received while
the men were in the prone position were not uncommon, but it was
remarkable how rarely the shoulder-joint was implicated in these. The
question of the narrow nature of the cleft exposed also comes up in this
position. As far as my experience went, injuries to the lower portion of
the capsule accompanying wounds of the axilla were those most often met
with. The ease and neatness with which pure perforations of the head of
the humerus can be produced was also an important element in the
frequent escape of this joint. No case of fracture of the glenoid cavity
happened to come under my notice.

I saw few instances in which the joint needed incision, and cannot
recall or find in my notes any case in which serious trouble arose.

_Elbow-joint._--Injuries to this joint came second in frequency in my
experience to those of the knee. They were, in fact, comparatively
common, especially in conjunction with fractures of the various bony
prominences surrounding the articulation. Fractures of the lower end of
the humerus were of worse prognostic significance than those of the
ulna, on account of the greater tendency to splintering of the bone. I
saw several cases of pure perforation of the olecranon without any signs
of implication of the elbow-joint. In a case which has been utilised for
the illustration of some of the types of aperture (fig. 20, p. 59), at
the end of a week there was no sign of any joint lesion, although the
bullet had obviously perforated the articulation.

Several cases of suppuration which came under my notice did well. I saw
one of them a few days ago, six months after the injury, with perfect
movement. In another of which I took notes, the bullet entered over the
outer aspect of the head of the radius, to emerge just above the
internal condyle anteriorly. A considerable amount of comminution of the
olecranon resulted, and when the man came into hospital some ten days
later the joint was suppurating. The joint was op