morrhage than those of the
kidney. I heard of a few cases in which this occurred, although I never
saw one. Case 204 is of considerable interest as illustrating the result
of an injury to one of the large bile ducts. Putting the deaths from
primary haemorrhage on one side, the prognosis in hepatic wounds was as
good as in those of the kidneys. A few fairly uncomplicated cases are
quoted below, but wounds of the liver occurred in connection with a
large number of other injuries both of the chest and abdomen, and except
in the case of wound of the stomach, recorded on page 425, No. 164, and
in case 188, I never saw any troublesome consequences ensue.

_Nature of the lesions._--I never saw any case of so-called explosive
lesion of the liver, such as have been described from experimental
results; this may have been due to the fact that such patients rapidly
expired, but such were never admitted into the hospitals.

The most favourable cases were those in which a simple perforation was
effected; such were usually attended by a practical absence of symptoms,
unless a large bile duct had been implicated, when a temporary biliary
fistula resulted.

Biliary fistulae were, however, much more common when the bullet scored
the surface of the organ. One such case is recounted under the heading
of injuries to the stomach, No. 164. Here a deep gaping cleft with
coarsely granular margins extended the whole antero-posterior length of
the under surface of the left lobe, and the escape of bile was free.
This was the nearest approach to one of the so-called explosive injuries
I met with.

Case 207 is an example of a superficial injury from a bullet possibly of
small calibre in which a superficial groove was followed by temporary
escape of bile, and it is of interest to note a very similar condition
in a shell injury (No. 210) recorded on p. 477.

Although both these cases recovered, I think notching and superficial
grooving must be considered much more serious injuries than pure
perforation. (See case 188, p. 442.)

The symptoms observed in these injuries have been already indicated in
the above description of the nature of the lesions. They consisted in
the pure perforations of practically nothing, in the grooves or the
perforations implicating a large duct in the escape of bile. In two of
the cases in which a biliary fistula was present transient jaundice was
noticed.

In many cases the accompanying wound of the diaphragm gave ri