and exit quite
healed. Cannot flex right thigh. The following operation was
performed. Appendix incision, about [Symbol: ounce]j of faecal
fluid and faeces in a localised cavity on outer and anterior
aspect of caecum evacuated; adhesions very firm. Cavity sloughy
throughout and caecum covered with dull grey lymph. The opening
in the bowel was not localised, and it was considered wiser to
treat the case like one of perforation from appendicitis than
to run the risk of breaking down adhesions. A small awl-like
opening was found in the ilium with powdered bone at its
entrance leading to the wound of exit.

The after-treatment of the case gave rise to no anxiety, but
healing of the resulting sinus was slow; faecal-smelling pus
escaped for some days, and a number of small sloughs came away.
On the twelfth day the patient was sent down to Wynberg, where
he remained twelve weeks. A counter-incision was needed in the
loin to drain the suppurating cavity three weeks after the
primary operation, and five weeks after the operation an escape
of gas and faeces took place from the anterior wound, while the
bowels were acting, as a result of a dose of castor oil. No
further escape of faeces occurred, and he left for England with
a small sinus only. No extension of inflammation into the
original wound track ever occurred, both openings and the canal
healing by primary union.

The sinus remained open, and occasionally discharged for a
further period of six months, and then healed firmly; since
when the patient has been in perfect health.

(182*) _Splenic flexure, descending colon._--Wounded at
Magersfontein. _Entry_ (Mauser), in sixth left intercostal
space in mid-axillary line; _exit_, in left loin, below last
rib, at outer margin of erector spinae. The patient remained in
the Field hospital three days, during which time he exhibited
no serious abdominal symptoms, but during the journey to Orange
River (53-1/2 miles) he was sick. He remained at Orange River
two days, and while there an enema was administered, producing
a normal motion. The abdomen was slightly distended; it moved
fairly, there was slight rigidity, but little tenderness.
Temperature 100.8 deg., pulse 120. No appearance of faeces in wound.

When seen on the sixth day the conditi