(202) _Wound of right kidney. Traumatic
hydronephrosis._--Wounded at Magersfontein. _Entry_
(Lee-Metford), in the eleventh intercostal space in the
posterior axillary line; _exit_, in the tenth right interspace,
in mid axillary line. The patient was in the prone position
when struck, and lay on the field from 5 A.M. until 6 P.M.
There was no sickness, and the bowels did not act. When seen on
the fourth day he was cheerful, but in some pain. The abdominal
wall moved well, but was rigid; there was some general
distension, and very marked local distension of the gastric
area extending across to the right, so that a depressed band
extended between the upper and lower parts of the belly. There
was marked local dulness in the right flank, which did not
shift on movement; the abdomen was elsewhere tympanitic. Tongue
furred, bowels confined; there has been no sickness, and no
haematemesis. Urine normal, and in good quantity. Temperature
100 deg.. Pulse 84, good strength. There was impairment of
sensation in the area of distribution of the external cutaneous
and crural branch of the genito-crural nerves.

On the sixth day the bowels acted, after the administration of
[Symbol: ounce]j of sulphate of magnesia, and the distension was
much lessened, although the belly retained its unusual
appearance. The dulness in the flank was unaltered. Temperature
100.8 deg., pulse 92.

A week later the man was much improved, suffering no pain.
Temperature ranged from 99 to 100 deg., and the pulse about 80. The
abdomen was normal in appearance, except for general prominence
of the right thorax in the hepatic area.

During the third week a large tympanitic abscess developed at
the aperture of exit, and this was opened (Mr. S. W. F.
Richardson) through the chest, and a large collection of
foul-smelling pus, but no faecal matter, evacuated. The patient
again improved, but a fortnight later a swelling and apparent
signs of local peritonitis developed in the right inguinal and
lower umbilical and lumbar regions. An incision made over this,
however, disclosed a normal peritoneal cavity and was closed.

At the end of ten weeks the patient was sent to the Base
hospital; a large firm swelling was then evident, extending
from the liver to the inguinal regio