men did, however, drink freely, and in one case which
terminated fatally a comrade gave a man wounded through the belly an
immediate dose of Beecham's pills.

(2) Mr. Treves has suggested that the effect of the severe trauma on the
muscular coat of the bowel is to cause a cessation of peristaltic
movement. This, as in the case of 'local shock' elsewhere, may no doubt
be of importance, and to it should be added the simultaneous cessation
of abdominal respiratory movements in the segment of the belly wall
covering the injured part. The occurrence of general cessation of
peristaltic movement is, however, to some extent opposed by the fact
that in a certain number of the cases early passage of motions was seen
just as happens in the intestinal ruptures seen in civil practice.

I should be inclined to ascribe the escape from serious infection in
these injuries to the same cause which accounts for their comparative
insignificance in other regions--namely, the small calibre of the bullet
and consequent small size of the lesion: in point of fact to the minimal
nature of the primary infection. I very much doubt if any patient who
had more than one complete perforation of the small intestine got well
during the whole campaign. This opinion is, moreover, supported by the
fact that the prognosis was so far better in cases of injury to the
large than to the small intestine, in which former segment of the bowel
we have the advantages of a position beyond the region in which
intestinal movement is most free, the unlikelihood of multiple injury,
and a drier and more solid type of faecal contents.

In the instances in which recovery followed perforating injuries without
any bad signs we can only assume a minimal infection, and sufficient
irritation and reaction on the part of the bowel to produce rapid
adhesion between contiguous coils, and thus provisional closure.

The other mode of spontaneous recovery which I saw several times take
place in the injuries to the large bowel consisted in the limitation of
the spread of infection by early adhesions and the development of a
local abscess. The non-observance of this process in any case of injury
to the small intestine raises very great doubts in my mind as to the
frequent recovery of patients in whom the small intestine was
perforated.

INJURIES TO THE INTESTINAL TRACT

1. _Wounds of the stomach._--A considerable number of wounds in such a
situation as to have possibly implicated