illustrate a fact that would scarcely have been assumed, that these
bullets on impact occasionally suffer a fracture of a somewhat
crystalline nature. The occurrence of this gross form of fracture is of
some interest in relation to the extreme fragmentation sometimes
undergone by the hardened leaden cores of the small-calibre bullets.

A considerable number of wounds from leaden shrapnel bullets were met
with among our own men, as well as among the Boers. The wounds possessed
little special interest, except from the fact that the bullets were
often retained. I saw bullets in the chest on several occasions, also in
the abdomen, pelvis, the neighbourhood of joints, and in the limbs.

I saw one patient who had suffered no less than six perforating wounds
as the result of the bursting of one shrapnel shell.

I will here quote one case of interest as completing the various forms
of perforating wound of the abdomen met with during the campaign.

[Illustration: FIG. 96.--Normal, Deformed, and Fractured Leaden Shrapnel
Bullets]

(212) _Perforating shrapnel-wound of abdomen._--Boer wounded at
Graspan. Aperture of _entry_ (shrapnel), opposite eighth left
costal cartilage, 1 inch external to nipple line. The opening
was circular, and surrounded by an area of ecchymosis 4 inches
in diameter; _exit_, 4-1/2 inches above and to the right of the
umbilicus. Patient was at first in a Boer ambulance, and only
seen by me on the ninth day. At that date he was dressed and
walking with a gauze pad and bandage over the wounds. From the
exit wound, which was 1 inch in diameter, protruded a piece of
sloughing omentum, the margin of the wound being everted and
raised over a circular indurated area.

It was thought best to allow the sloughing omentum, which was
very foul, to separate spontaneously, and then to return the
stump. At the end of three weeks, however, the slough had not
only separated, but the stump had retracted, and only a small
granulating surface was left, which healed spontaneously.

I have little to say regarding the treatment of shell wounds. The
mutilating injuries, if not of a fatal character, necessitated treatment
of a corresponding nature to the damage. In all such cases the general
rules of surgery indicate the lines to be followed.

In the case of shrapnel wounds the bullets were often better removed;
but when in dangerous positions,