on was as
follows:--Patient cheerful and not in great pain. Temperature
99.2 deg.; pulse 120; respirations 48, very shallow. Abdomen soft,
moving freely, no distension or general tenderness. Fluid faeces
escaping in abundance from the wound in loin. Redness of skin
and swelling below level of wound, and cellular emphysema
above. Faecal-smelling fluid was also escaping from the thoracic
wound.

The wound was enlarged, but the patient rapidly sank, and died
of septicaemia on the seventh day.

(183*) An exactly similar case came under observation from the
battle of Modder River, except that the opening in the loin was
somewhat larger, and earlier and freer escape of faeces took
place from it. In this also faecal matter passed freely into the
left pleural cavity, and faecal matter was expectorated, while
there was an almost complete absence of abdominal symptoms.
Death occurred on the fourth day.

No _post-mortem_ examination was made in either case, but I
believe in both the extra-peritoneal aspect of the colon was
implicated and that the septicaemia was in great part due to
absorption from the pleural rather than the peritoneal cavity,
since in neither case were the abdominal symptoms a prominent
feature.

(184) _Possible wound of caecum._--Wounded at Spion Kop. Bullet
(Mauser) perforated the right forearm, then entered belly.
_Entry_, 3 inches from the right anterior superior iliac spine,
in the line of the supra-pubic fold of the belly wall (a
transverse slit); _exit_, in right buttock, on a level with the
tip of the great trochanter and 2 inches within it. The wound
was received immediately after breakfast had been eaten. There
was retention of urine and constipation for three days, but no
sickness. Local pain and tenderness were severe, and at the end
of three weeks there was still local tenderness, slight
induration, and dragging pain on defaecation. The patient
returned to England at the end of a month well, except for
slight local tenderness.

(185) _Possible wound of colon._--Wounded at Paardeberg; range
200 yards. Walking at time. The bullet (Mauser) perforated the
left forearm, just below the elbow-joint. _Entry_, into belly 1
inch anterior to the tip of the left eleventh costal cartilage;
no exit.

T