t innocuous nature. The absence of subsequent suppuration,
however, was definitely opposed to this view, and suggested that the
fever resulted from absorption of some element of the blood, possibly
the fibrin ferment, or some form of albumose. A pronounced illustration
was in fact afforded of the evanescent rise of temperature usually the
accompaniment of simple fractures in the case of the limbs, and of the
more marked rise not uncommon in cases of traumatic blood effusion into
the peritoneal cavity, or when the pleurae or joints were the seats of
the mischief. In the case of interstitial haemorrhages I only remember to
have seen fever of such marked continued type in the subjects of
haemophilia with recent effusions, although one is of course acquainted
with it in a less pronounced form as a result of haemorrhage into
operation wounds.

In primary interstitial haemorrhages a similar continued rise of
temperature was also common, and I cannot perhaps better illustrate its
character than by the brief relation of two instances.

In a patient wounded at Kamelfontein the bullet entered four inches
below the acromion, pierced the deltoid, splintered the humerus, and
crossed the axilla. A large blood extravasation developed in the axilla,
accompanied by cutaneous ecchymosis extending halfway down the arm.
There was no perceptible pulsation in either the brachial or radial
artery, but the limb was warm. There was partial paralysis of the parts
supplied by the ulnar and musculo-spiral nerves and complete loss of
power and sensation in the area of distribution of the median nerve. Six
months later the radial pulse was still absent in this patient, but
there was no sign of the development of an aneurism.

[Illustration: TEMPERATURE CHART 1.--Axillary Haematoma. Shows range of
temperature during process of absorption and consolidation without
suppuration]

The accompanying temperature chart is characteristic. The blood
effusion gradually gained in consistency and underwent steady diminution
in size. No suppuration occurred.

The median paralysis was found to be accompanied by the inclusion of the
nerve in a sort of foramen of callus, when the patient was explored at a
later date by Mr. Ballance.

In a patient wounded at Paardeberg, a Mauser bullet entered by the left
buttock, pierced the venter ilii, traversed the pelvis, and emerging at
the brim of the latter, crossed the back, fractured the spine of the
fourth lumbar ver