iate results of the
injuries are known to us, while the more important after consequences
remain to be followed up.

As to life the immediate prognosis has been already foreshadowed in the
section on the anatomical lesions. It is there shown that the first
point of general importance is the range of fire at which the injury has
been received. At short ranges, as evidenced by the history, the
characters of the wounds, and the severity of the symptoms, the
immediate prognosis was uniformly bad, a very great majority of the
patients dying, and that at the end of a few hours or days.

The rapidity with which death followed depended in part on the actual
severity of the wound, and still more on the region it affected; the
nearer the base and the longer the track the more rapidly the patients
died, and this always with signs of failure of the functions of the
heart and lungs due to general concussion, pressure from basal
haemorrhage, or rapid intracranial oedema. In my experience no patients
survived direct fracture of the base in any region but the frontal,
although many, no doubt, got well in whom fissures merely spread into
the middle or posterior fossa. Patients with very extensive injuries at
a higher level, on the other hand, often survived days, or even a week,
then usually dying of sepsis.

The actual relative mortality of these injuries I can give little idea
of, but it was a high one both on the field and in the Field hospitals;
thus of 10 cases treated in one Field hospital, after the battle at
Paardeberg Drift, no less than 8 died; while of 61 cases from various
battles who survived to be sent down to the Base during a period of some
months, only 4 or 6.55 per cent. died. Many of the latter, as is seen
from the cases here recorded which were among the number, were none the
less of a very serious nature. The early causes of death in patients
dying during the first forty-eight hours have been already mentioned;
the later one was almost always sepsis.

As in civil practice the best immediate results were seen in injuries to
the frontal lobes, and after these in injuries to the occipital region.
In the latter permanent lesions of vision were, however, common. The
above injuries apart, the prognosis depended on the severity and depth
of the lesion. The frequency and extent of radiation symptoms often made
it possible to give a more hopeful prognosis than the immediate
conditions seemed to warrant, if the exact situ