rapidly absorbed. In the latter case, however, there was
little reason to conclude that wound of the lung had occurred primarily,
and certainly no opening existed at the time the thorax was incised.

_Haemothorax._--This was the most frequent and also the most interesting
of the complications of wound of the chest. In 90 per cent. or more of
the cases, the haemorrhage was of parietal source, and due either to
direct injury to the intercostal vessels by the bullet or to laceration
by spicules of comminuted ribs. For this reason, the passage of the
bullet whether by an intercostal space, or through a rib, provided the
wound was not at the posterior part of the space where the artery
crosses, was a point of considerable prognostic importance. Exclusion of
the lung as the source of haemorrhage was, I think, amply justified by
the absence of continuous recurrent or progressive haemoptysis in the
majority of the cases, and by the very small trace of injury found in
the lungs of patients who died some weeks after the injury. In such it
was difficult to discriminate the tracks at all. I only happened to see
one case where free haemoptysis, during the course of development of a
haemothorax, pointed to the lung as the source of the blood.

Haemorrhage into the pleural cavity occurred in some degree in a very
large proportion of the chest wounds, but it was especially interesting
to note how greatly its extent was influenced by the amount of transport
to which the patients were subjected in the early stages after the
injury. During the early part of the campaign, on the western side, I
saw a large number of chest wounds, and had I been asked my opinion as
to the relative frequency of occurrence of haemothorax I should have
placed it at about 30 per cent. The patients in these early battles
needed little wagon transport, and when sent down to the Base travelled
in comfortable ambulance trains. After the commencement of the march
from Modder River to Bloemfontein, however, these conditions were
changed, and all the chest as other cases were exposed to the necessity
of three days and nights' journey to the Stationary hospitals and
afterwards to the long journey to Cape Town. Of these patients, at
least 90 per cent. suffered with haemothorax of varying degrees of
severity.

In some cases, the least common, signs of considerable intra-pleural
haemorrhage immediately followed the wound; in others, the accumulation
of blood was gradua