sioned. The man appeared to steadily improve
until three weeks later, when the temperature, which throughout
had been uneven, became consistently high, and signs of fluid
at the base increased. An aspirating needle was introduced, and
16 ounces of pus were drawn off. Two days later a piece of rib
was resected (Mr. Pegg) and another pint of pus evacuated.
After this, rapid improvement took place, and in ten days the
man was able to be up and dressed, although a small amount of
discharge still persisted. He eventually made an excellent
recovery.

Secondary empyemata not uncommonly followed incision of the chest, or
excision of a rib for draining a haemothorax. These operations in the
early part of the campaign were more freely undertaken on the
supposition that rise of temperature and other symptoms of fever pointed
to incipient breaking down of the clot. Subsequent experience showed
this not to be the case, and early operations for drainage ceased to be
undertaken. In these operations a primary difficulty was met with in
effectively clearing out the clot, a drain had to be left, and
suppuration occurred later in a considerable proportion. The
suppurations were most troublesome; local adhesions formed, and the pus
collected in small pockets, which were difficult to find and to drain,
and even when the collections seemed to have been successfully dealt
with at the time, residual abscesses often followed at a very late date.
Thus, I saw a case with a contracted chest and a fresh abscess the day
before I left Cape Town, in whom I had advised and witnessed an
operation for the evacuation of clot in the presence of signs of fever a
week after my arrival in the country, nine months previously. I saw
another case where general infection followed incision of a haemothorax,
but the patient fortunately recovered.

The question of _pleurisy_ has already been mentioned in connection with
haemothorax; it no doubt accounted for secondary effusion in some cases,
and beyond this I have nothing to add to what has been there said.

_Pneumonia_ was rare; there were occasionally signs of consolidation,
but, I think, quite as often in the opposite lung as in the one injured.
I never saw a fatal case, and I am inclined to think that when it
occurred it was as often the result of cold and exposure as of the
injury to the lung. Abscess of the lung I only saw once, and that in a
case in which the in