ly appreciated in advance; but this alone scarcely accounted for
the want of success attending the active treatment of wounds of the
intestine when occasion demanded. Failure was rather to be referred to
the severity of the local injury to be dealt with, or to the operations
being necessarily undertaken at too late a date. Many fatalities, again,
were due to the association of other injuries, a large proportion of the
wound tracks involving other organs or parts beyond the boundaries of
the abdominal cavity.

The frequent association of wounds of the thoracic cavity with those of
the abdomen afforded many of the most striking examples of immunity from
serious consequences as a result of wound of the pleura. It must be
conceded that in a large number of such injuries only the extreme limits
of the pleural sac were encroached upon, yet in some the tracks passed
through the lungs, although without serious consequences. Under the
heading of injury to the large intestine a somewhat special form of
pleural septicaemia will be referred to.

It may at once be stated that such favourable results as occurred in
abdominal injuries were practically limited to wounds caused by bullets
of small calibre, and that, although in the short chapter dealing with
shell injuries a few recoveries from visceral wounds will be mentioned,
I never met with a penetrating visceral injury from a Martini-Henry or
large sporting bullet which did not prove fatal.

_Wounds of the abdominal wall._--It is somewhat paradoxical to say that
these injuries possessed special interest from their comparative rarity
of occurrence, since they were not of intrinsic importance. Their
infrequency depended on the difficulty of striking the body in such a
plane as to implicate the belly wall alone, and their interest in the
diagnostic difficulty which they gave rise to.

In many cases the position of the openings and the strongly oval or
gutter character possessed by them were sufficient proof of the
superficial passage of the bullet; in others we had to bear in mind that
the position of the patient when struck was rarely that of rest in the
supine position, in which the surgical examination was made, and
considerable difficulty arose. Some superficial tracks crossing the
belly wall have already been referred to in the chapter on wounds in
general and in that dealing with injuries to the chest, in which the
above characters sufficed to indicate that penetration of th