th the arrow-head in situ.

As quoted by Chelius, both Hennen and Cline relate cases in which men
have been shot through the skirts of the jacket, the ball penetrating
the abdomen above the tuberosity of the ischium, and entering the
bladder, and the men have afterward urinated pieces of clothing,
threads, etc., taken in by the ball. In similar cases the bullet itself
may remain in the bladder and cause the formation of a calculus about
itself as a nucleus, as in three cases mentioned by McGuire of
Richmond, or the remnants of cloth or spicules of bone may give rise to
similar formation. McGuire mentions the case of a man of twenty-three
who was wounded at the Battle of McDowell, May 8, 1862. The ball struck
him on the horizontal ramus of the left pubic bone, about an inch from
the symphysis, passed through the bladder and rectum, and came out just
below the right sacrosciatic notch, near the sacrum. The day after the
battle the man was sent to the general hospital at Staunton, Va., where
he remained under treatment for four months. During the first month
urine passed freely through the wounds made by the entrance and exit of
the ball, and was generally mixed with pus and blood. Fecal matter was
frequently discharged through the posterior wound. Some time during the
third week he passed several small pieces of bone by the rectum. At the
end of the fifth week the wound of exit healed, and for the first time
after his injury urine was discharged through the urethra. The wound of
entrance gradually closed after five months, but opened again in a few
weeks and continued, at varying intervals, alternately closed and open
until September, 1865. At this time, on sounding the man, it was found
that he had stone; this was removed by lateral operation, and was found
to weigh 2 1/4 ounces, having for its nucleus a piece of bone about 1/2
inch long. Dougherty reports the operation of lithotomy, in which the
calculus removed was formed by incrustations about an iron bullet.

In cases in which there is a fistula of the bladder the subject may
live for some time, in some cases passing excrement through the
urethra, in others, urine by the anus. These cases seem to have been of
particular interest to the older writers, and we find the literature of
the last century full of examples. Benivenius, Borellus, the
Ephemerides, Tulpius, Zacutus Lusitanus, and others speak of excrement
passing through the penis; and there are many cases of v