occur in
wounds the first dressing of which is often delayed, and which happen to
men sweating freely into clothes the condition of which is at least
undesirable for contact with a recent wound. Beyond this, the first
dressing materials, removed from a soiled tunic by possibly a comrade or
a stretcher-bearer, are scarcely above reproach of the probability of
containing septic organisms themselves. Again, once applied, the
exigencies of the situation often necessitate an amount of movement
fatal to the retention of the dressing over the wound, and a second
opportunity of infection arises before the patient comes into the hands
of the surgeon in the Field hospital.

The general tendency of such suppurations when they occurred in
uncomplicated flesh wounds was to remain superficial, either involving
the contused margin of the cutaneous opening and the plug of blood-clot
occupying it, and resulting in a slight enlargement of the wound only,
or at most involving the subcutaneous tissue and not extending into the
deep planes of the trunk or limbs. In either case a slight delay in
healing was the most serious result, while constitutional signs of
infection were either absent or of the slightest nature. The same
indisposition to spread by the track was equally noted when a deep
portion became infected from, for instance, the intestine in a belly
wound.

Wounds of irregular type, however, such as those caused by ricochet
bullets, or accompanying severe fractures, or those caused by fragments
of larger projectiles, often suppurated freely in spite of exposure to
no more unsatisfactory surrounding conditions than the wounds of small
bore. This appears to show conclusively that the first element in the
general slight consequences of small-bore wounds is their calibre, and,
secondly, that increase of velocity on the part of the bullet, while it
in some measure compensates for the loss of volume in the projectile, on
the other hand reacts in favour of the wounded in so far as the injuries
it effects on the soft tissues are ill suited to the development of
septic organisms in the parts.

_Retained bullets._--These were met with more frequently than might have
been expected, but I can give no idea as to their proportional
occurrence, since so many of the slighter injuries never came under my
observation. Experience, however, showed that the bullets of large
calibre and low velocity employed during the campaign were far more
common