ar
urine was withdrawn from the bladder by catheter, and an
incision was made into the thigh just below the inner third of
Poupart's ligament, where fluctuation was evident. Two pints of
bloody urine were evacuated, and when a finger was introduced
it passed over a fracture of the pubes into the pelvis, but not
into the peritoneal cavity. In view of the patient's condition
it was not thought wise to proceed further, and he somewhat
improved later, and was sent to the Base. Loss of power in the
right lower extremity pointed to injury to the anterior crural
nerve.

On the patient's arrival at Wynberg there were signs of local
peritonitis in the lower half of the abdomen, and all his urine
was passed from the wound in the left thigh. Some days later
this wound was enlarged to allow of the freer exit of pus, and
a fragment of bone was removed. The wound granulated healthily,
but the man steadily emaciated and lost ground, with signs of
chronic septicaemia, and he died on the twenty-first day. At the
_post-mortem_ examination a transverse wound of the anterior
wall of the bladder behind the pubes, below the peritoneal
reflexion, was found gaping somewhat widely, and 2 inches in
length. There was little sign of previous peritonitis. The
retained bullet was discovered beneath the femoral vessels in
the left thigh.

(196) _Extra-peritoneal perforation of the bladder._--Wounded
at Paardeberg. _Entry_ (Mauser), 3 inches above the left tuber
ischii; _exit_, above the symphysis, immediately over the right
margin of the penis. The patient was retiring to fetch
ammunition when shot. Urine was noted to escape from both
apertures the day after, and this continued until he was sent
down to the Base on the fourteenth day. The patient was then
considerably emaciated, complained of great pain, especially
down the left thigh (sciatic nerve), the temperature averaged
100 deg., the pulse 80, tongue clean and moist, bowels acted
regularly, no sign of injury to the rectum. He was taking food
fairly, but was very sleepless. Urine was passed per urethram,
and also escaped by both wounds. The abdomen was flaccid and
sunken, respiratory movements being confined to the upper half.

As there was evidence of considerable infiltration in the
buttock, the o