any cases a simple puncture no doubt alone existed, an injury
no more to be feared than the exploratory punctures often made for
surgical purposes. In other cases the wounds may have been of the nature
of notches and grooves.

Two of the cases recounted below were of a more severe variety; in one
(No. 201) both kidneys were implicated by symmetrical wounds of the
loin, and in the case of the right organ a transverse rupture was
produced, which was followed by the development of a hydro-nephrosis,
and later by suppuration. This injury was probably the result of a wound
from a short range, as the patient was one of those wounded in the early
part of the day at the battle of Magersfontein. It was complicated by a
wound of the spleen and an injury to the spinal cord producing
incomplete paraplegia accompanied by retention of urine. The last
complication was responsible for the death of the patient, since
ascending infection from the bladder led to the development of
pyo-nephrosis and death from secondary peritonitis.

Case 202 is an instance of a transverse wound of the upper part of the
abdominal cavity; it is impossible to say what further complications
were present. The early development of a tympanitic abscess suggested an
injury to the colon, but this was not by any means certain. The
condition of the kidney was very likely similar to that in the last
case, but the ultimate recovery of the patient left this a matter of
doubt. The case was also one dependent on a short-range wound, since the
patient, one of the Scandinavian contingent, was wounded at
Magersfontein during close fighting.

The common history of the symptoms after a wound of the kidney was
moderate haemorrhage from the organ, persisting for two to four days. In
one of the cases recounted below the haematuria was accompanied by the
passage of ureteral clots, but this was not a common occurrence.

For the sake of comparison I have included one case of wound of the
kidney from a large bullet, in which death was due to internal
haemorrhage. In this instance the injury was a complex one, the lung
certainly, and the back of the liver probably, being concurrently
injured. None the less if the same track had been produced by a bullet
of small calibre I believe the injury would not have proved a fatal one.
I never saw such free renal haemorrhage in any of the Mauser or
Lee-Metford wounds.

(197) _Wound of right kidney._--Wounded at Modder River while