iminary puncture, the man refused any further
operative treatment, although a second rise of temperature
commenced on the fifteenth day, culminating in a temperature of
103.2 deg. on the eighteenth. The further treatment of the patient
consisted in the ensurance of rest and the alleviation of pain.
A steady fall in the temperature extended over another three
weeks, together with diminution in the signs of fluid in the
pleura. At the end of seventy-four days the man was sent home,
some slight dulness at the left base, and contraction of the
chest sufficient to influence the spine in the way of lateral
curvature, being the only remaining signs.

[Illustration: TEMPERATURE CHART 4.--Primary Haemothorax. Secondary rise
of temperature, with increase in the effusion. Spontaneous recovery.
Case No. 155]

(155) _Severe haemothorax. Secondary effusion. Spontaneous
recovery._--Wounded at Koodoosberg Drift, at a distance of 200
yards. _Entry_, at angle of the right scapula; _exit_, at the
junction of the left anterior axillary fold with the
chest-wall. No signs of spinal cord injury. The patient was
brought in from the field twelve miles by an ambulance wagon on
the second day, and in crossing the Modder River he was
accidentally upset into the stream. For the first four days
there was no haemoptysis, but for the succeeding nine days small
brightish red clots were expectorated. There was some
tenderness over the ribs from the fifth to the ninth in the
axillary line, and on the ninth day some gravitation ecchymosis
appeared over the same region. Cough was an early troublesome
symptom in this case, and when admitted to the Base hospital,
about the seventh day, there was evidence of fluid extending
about a third of the way up the back.

On the tenth day after admission a pleural rub was detected at
the upper margin of the dulness, and the latter shortly
extended upwards over a little more than half the back.
Meanwhile, there was no further haemoptysis, respiration was
fairly easy, 24 per minute, but accompanied by slight
dilatation of the alae nasi, and the temperature, which had been
ranging from 99 deg. to 100 deg., began to rise steadily, on the
fifteenth day reaching 102.5 deg.. The patient refused even an
exploratory puncture, and was treated on the exp