bacute form; thus I saw several
patients recover after secondary abscesses had been opened, or the
primary focus of infection removed. The only really acute case of joint
pyaemia I heard of, developed in connection with a blistered toe followed
by cellulitis of the foot.

Cutaneous erysipelas I never happened to see, and really acute
phlegmonous inflammation was rare.

I may mention the occurrence of acute traumatic gangrene in two cases.
This developed in each instance with gunshot fracture of the femur; in
one amputation was performed, and the process extended upwards on to the
abdomen. The cases occurred with the army in the field in the
neighbourhood of Thaba-nchu and not in a stationary hospital.

Acute traumatic tetanus occurred only in one instance to my knowledge.
In this case the primary injury was a shell wound of the thigh, and the
patient developed the disease and died within ten days.

To the civil surgeon the performance of operations, and the dressing of
severe wounds at the front, proved on occasions a somewhat trying
ordeal.

When operations were necessary in the field, during the daytime, it was
often possible to perform them in the open air, provided tolerable
protection could be obtained from the sun. A number of cases were so
operated upon during the march of the Highland Brigade from Wynberg to
Heilbron, and gave excellent results, the patients deriving considerable
benefit from the early cleansing and closure of the wounds.

[Illustration: FIG. 13.--Tortoise Hospital Tent. Portland Hospital.
(Photo by Mr. C. S. Wallace)]

In camp, in the Field, or Stationary hospitals, the difficulties were
often much greater. The operations were necessarily performed under
shelter for reasons of privacy. In the tents the draught carrying the
dust from the camp was one of the commonest troubles. The exclusion of
dust was impossible, and it not only found its way into open wounds, but
permeated bandages with ease. Often when a bandage was removed, an even
layer of dust moistened by perspiration covered the whole area included
with a coating of mud. Again, in dust storms a similar layer of mud
sometimes covered the whole of the exposed parts of the bodies of
patients lying on the ground in the tents.

It is of some interest to remark with regard to this dust, that Dr. L.
L. Jenner lately kindly examined a specimen collected at Modder River
after the camp had been more than two months established, and discov