inued
for two days.

Ten days after the injury the temperature was still rising to
100 deg., and did not become normal till the fourteenth day. The
pulse averaged 80. The abdomen, meanwhile, moved fairly well,
respirations 18 to 20. Some tenderness was present in the
epigastrium and towards the spleen. Resonance throughout.
Ordinary diet was now resumed, and beyond slight epigastric
pain on deep inspiration, no further symptoms were observed,
and the patient left for England at the end of the month. The
spleen may have been traversed in this patient, as well as the
lower margin of the right lung.

(164*) Wounded at Enslin. _Entry_ (Mauser), 3/4 of an inch from
the spine, opposite the eighth intercostal space; _exit_,
through the seventh left costal cartilage, 1 inch from the
median line. The patient was lying in the prone position when
shot: he vomited blood freely, and the bowels acted three times
before he was seen forty hours after the accident, each motion
containing dark blood.

On the commencement of the third day the patient's expression
was extremely anxious, and he was suffering great pain. Pulse
96, temperature 100 deg.. Tongue moist, occasional vomiting, bowels
open yesterday. Has taken fluid nourishment since injury. The
abdomen moved with respiration, but was moderately distended,
especially in the line of the transverse colon; it was
tympanitic on percussion, there was no dulness in the flanks,
and only moderate rigidity of the wall on palpation. Frothy
fluid stained with bile and faecal in odour was escaping from
the wound of exit, and the everted margins of the latter were
bile-stained.

A vertical incision was carried downwards from the wound for 4
inches. A rugged furrow was found on the under surface of the
left lobe of the liver; the stomach was contracted and firmly
adherent by recent lymph to the under surface of the liver and
the diaphragm. The transverse colon was much distended. On
separating the stomach a slit wound was found at the lesser
curvature, immediately to the right of the oesophagus. This
wound was closed with some difficulty with two tiers of
sutures; the cavity was mopped out, and then irrigated with
boiled water; a plug was introduced along the line of the
furrow in the liver, a