t opening was very large and on
the outer aspect of the limb in the upper third. The bullet had
apparently passed between the bones. Secondary haemorrhage from the
anterior tibial artery necessitated exploration of the wound and
ligature of the vessel (Mr. Carre). When the wound was thus laid open no
injury to the bones could be detected, but I do not consider that it
could be actually excluded. In the second case a wound traversed the
calf transversely, just above the centre; the exit aperture was large
and ragged. Deep suppuration occurred, and the wound had to be laid
open, when a fracture of the tibia without solution of continuity was
discovered. I also saw one or two wounds of the buttock in which very
large exit apertures were present with small entry openings; in these
again it was impossible to exclude passing contact of the bullet with a
part of the pelvic wall. Unfortunately in all these cases it is
impossible to obtain the bullet responsible for the injury. In this
relation I append a diagrammatic illustration of a peculiar wound shown
to me by Mr. Hanwell. In this case a typical small entry wound was
situated at the outer margin of the left erector spinae muscle in the
loin. The bullet had taken a subcutaneous course of not more than
three-quarters of an inch, while the exit opening was a long shallow
wound measuring 4-1/2 in. in length by 1-1/2 in. width. (Fig. 44.)

The wound was stated to have been received at a distance of from fifty
to a hundred yards. I think we can scarcely assume that impact with the
margin of the erector spinae could have resulted in 'setting up' of the
bullet, while an irregular tongue of skin at the point where the wound
crossed the spines of the lumbar vertebrae did suggest possible bony
contact. That the latter must have been of the slightest nature is
evident, as no signs of concussion of the spinal cord were noted. I
should rather be inclined to compare this case to one of gutter wound
quoted on p. 56, and to assume that the bullet passed so closely
beneath the surface as either to entirely sever the skin, or at any rate
to allow it to give way on flexion of the back on movement.

[Illustration: FIG. 44.--Small Circular Entry, large 'explosive' skin
wound of back. Track only an inch or less in length (see text)]

On the ground of the observations made in the foregoing pages it will be
gathered that the opinion I formed was against either the very free use
or the great wound