on the sixth day; he said he
expectorated some blood at the end of about ten minutes after
being shot, and experienced a 'half-choking sensation.' A small
quantity of phlegm and occasional clots had been expectorated
since. He had walked about a good deal; movement occasioned
cough, and he became 'blown' very rapidly.

On admission there were signs of fluid in the lower third of
the pleural cavity, but no general symptoms beyond an evening
rise of temperature to an average of 99 deg.. About the twentieth
day the temperature commenced to rise, and on the twenty-third
and four following evenings reached 102 deg.. The fever was
accompanied by some distress, and a well-marked increase in the
physical signs of the presence of fluid in the chest. The pulse
rose to 96, and the respirations considerably above the average
of 24, which was at first noted. A strictly expectant attitude
was maintained, and the temperature steadily fell in a curve
corresponding to the rise, gradually reaching the normal at the
end of a week. The physical signs at the base steadily cleared
up, and at the end of six weeks the patient returned to England
convalescent.

CHAPTER XI

INJURIES TO THE ABDOMEN

Perhaps no chapter of military surgery was looked forward to with more
eager interest than that dealing with wounds of the abdomen. In none was
greater expectation indulged in with regard to probable advance in
active surgical treatment, and in none did greater disappointment lie in
store for us.

Wounds of the solid viscera, it is true, proved to be of minor
importance when produced by bullets of small calibre; but wounds of the
intestinal tract, although they showed themselves capable of spontaneous
recovery in a certain proportion of the cases observed, afforded but
slight opportunity for surgical skill, and results generally deviated
but slightly from those of past experience. Such success as was met with
depended rather on the mechanical genesis and nature of the wounds than
upon the efforts of the surgeon, and operative surgery scored but few
successes.

It is true that to the Civil Surgeon accustomed to surroundings replete
with every modern appliance and convenience, and the possibility of
exercising the most stringent precautions against the introduction of
sepsis from without, abdominal operations presented difficulties only
faint