uirements, but the patients often object to them. Cases
in which the fragments could be fixed by wiring the teeth were not
common, as the latter had so frequently been carried away. The usual
precautions as to maintaining oral asepsis were especially necessary.

The results of fractures of the mandible were, in so far as my
experience went, remarkably good, as deformity was seldom considerable.
The absence of obliquity and the effect of primary local shock were no
doubt favourable elements, little primary displacement from muscular
action occurring.

Wounds of the _cheek_ healed readily, and the same was noticeable of the
lips. Wounds of the _tongue_ healed with remarkable rapidity when of the
simple perforating type, often with little or no swelling or evidence of
contusion. At the end of a few days it was often difficult to localise
them.

In connection with this subject a remarkable case which occurred at the
fighting at Koodoosberg Drift is worthy of mention, although the
projectile was a shell fragment and not a bullet of small calibre.

(84) A Highlander was the unfortunate possessor of an entire
set of upper teeth set in a gold plate. A small fragment of a
shell perforated the upper lip by an irregular aperture, and
struck the teeth in such a manner as to turn the posterior edge
of the plate towards the tongue, which latter was cut into two
halves transversely through to the base.

The patient asserted that the plate had been driven down his
throat, but nothing was palpable either in the fauces or on
external examination of the neck. He spoke distinctly, but
there was dysphagia as far as solids were concerned.

On the second day swelling of the neck due to early cellulitis
developed, especially on the left side, and signs of laryngeal
obstruction became prominent. Chloroform was administered, but
on the introduction of the finger into the fauces, respiration
failed and a hasty tracheotomy had to be performed. No foreign
body was palpable with the finger in the pharynx.

Tracheitis and septic pneumonia developed, and the man died of
acute septicaemia thirty-six hours later. Death occurred just as
the Division received marching orders, and no _post-mortem_
examination was made. As a result of palpation at the time of
the tracheotomy, the probabilities seemed against the presence
of the tooth plate i