d the additional wound no doubt
proved the source of infection.

(152) _Entry_, at the posterior margin of the sterno-mastoid
muscle, 2 inches above the clavicle; the bullet came to the
surface beneath the skin over the fifth rib, in the nipple line
of the right side. There was never any haemoptysis, but the
patient suffered with some dyspnoea throughout. After a three
days' stay in the Field hospital, where the subcutaneous bullet
was removed, the patient was transported by wagon and train to
the Base, a journey of about 600 miles.

On the fifth day pus escaped from the extraction wound, and
when the case was examined at the Base, the temperature was
101 deg., the pulse over 100, the respirations 30, and the whole
side of the chest was dull, with the exception of a patch of
boxy resonance over the apex anteriorly. On the following day
the chest was drained, and a considerable amount of pus
evacuated, which was mixed with breaking-down blood-clot. A
fortnight later a second operation had to be performed to
improve the drainage, and the patient made a tedious recovery.

The following case well illustrates the symptoms in a severe case of
haemothorax, and empyema following aspiration:--

(153) The patient was wounded at Paardeberg at a range of from
500 to 700 yards. _Entry_, just to the left of the episternal
notch; _exit_, in the fifth left interspace posteriorly, midway
between the spine and vertebral margin of the scapula. A
quantity of bright blood was brought up at once, and later
blood was coughed up in clots.

There was no great pain at the moment of the injury; the man
again got up to the firing line, and later walked two miles to
the Field hospital without aid. He remained here a week, when
he was sent down to the Base, and during the first three days'
journey in the wagon he began to get worse. On the fourth day
cough began to be very troublesome.

When he arrived at the Base, fifteen days after the original
injury, there was much dyspnoea; the temperature was 102 deg.,
and the pulse 110. The left side of the chest was dull
throughout; an aspirating needle was introduced, and a pint of
very dark liquid blood drawn off. The whole of the blood was
not removed on account of the very severe cough and pain which
the evacuation occa