ished appear to substantiate the opinion. From our experience of the
occasional spontaneous recovery of gastric perforations from disease, I
think we might be prepared to expect that the stomach would offer a
comparatively favourable seat for these wounds. It may be pointed out,
however, that haematemesis, the main feature in the symptoms pointing to
wound, is by no means direct proof of more than contusion.

2. That perforating wounds of the small intestine are very fatal
injuries; every patient in whom the condition was _certainly_ diagnosed
died.

3. That in the cases in which a perforation was inferred from the
position of the external apertures and the symptoms, not one patient
suffered from the secondary complications--_e.g._ local peritonitis and
suppuration, which were common in the case of the large intestine, and
which we are accustomed to see after perforation from disease. This
renders the occurrence of actual perforation in the majority of the
cases a matter of very grave doubt.

If spontaneous recovery does take place after this injury, it is only in
cases in which the wounds are single, and slight in character.

4. That in eight cases in which perforation of the large intestine was
certain, four recoveries took place; but in each instance suppuration
occurred. I am, however, quite prepared to believe that perforation may
have occurred in some or all of the other four cases included as
'possible,' provided the wounds were intra-peritoneal.

Wounds of the caecum and ascending colon are those which have the best
prognosis, and after these of the rectum. The comparatively good
prognosis in these parts is what would be expected, on account of their
greater fixity, and lesser tendency to be covered by the small
intestine.

An extra-peritoneal wound of any of these portions of the bowel is more
dangerous than an intra-peritoneal, and more likely to give rise to
septicaemia.

Of the cases included in my table eighteen of the possible intestinal
injuries were observed among the wounded of the four battles of the
Kimberley relief force. These cases I saw early and followed to their
termination, and I believe the list contains the great majority of all
the patients who received intestinal wounds in those battles. On inquiry
I could not learn of others from the officers of the Field hospitals;
but no doubt some patients died before their reception into hospital,
and some may have been overlooked; again, I kno