oduced by
bullets of the Mauser type. Again, these injuries as a whole were of
nothing like so serious a nature as the lacerations of the lung produced
by fractured ribs, which we commonly have to treat in civil practice,
and are not accustomed to regard as especially dangerous.

It is also a striking fact that the most common and troublesome
complication of wounds of the chest, haemothorax, was usually the result
of the wound of the chest-wall and not of the lung. I preface these
remarks to the detailed account of the thoracic injuries, because I
think the favourable course usually taken by patients with wounds of the
lung has been accorded somewhat greater prominence than the
circumstances warranted.

_Non-penetrating wounds of the chest-wall._--Surface wounds were not
very common, and were chiefly of interest in so far as they illustrated
the very superficial course that may be occasionally taken by a bullet
without breach of the integument, and as sometimes affording opportunity
for the exercise of diagnostic skill when the track traversed the
axilla.

The most common situation for tracks taking a long course on the surface
of the thoracic skeleton was the back. Such wounds were usually received
while the patients were prone on the ground; thus I might instance a
case in which the bullet entered the posterior aspect of the shoulder 3
inches above the spine of the scapula, passed downwards, pierced that
process, and emerged 2 inches below the inferior angle of the bone.
Wounds of a similar nature coursing in transverse and oblique
directions, and not implicating bone, were also seen. Those implicating
the vertebrae have been already dealt with. The scapular region was also
a favourite one for the lodgment of retained bullets, some resting in
the supra- and infra-spinatus muscles, others lying beneath the bone
itself.

On the anterior aspect of the chest, bullets coming from the front
sometimes traversed and fractured the clavicle, and then took a short
course downwards, emerging over the ribs or sternum. Figure 81
represents a particularly long track in this region. In other cases the
precordial region was crossed, but I never witnessed any serious effect
on the heart's action in any such injury at the time the patients came
under my notice.

Wounds received with the arm outstretched and traversing the axilla
sometimes gave considerable trouble in excluding with certainty a
perforation of the thoracic cavity.