A year later the man had resumed active duty, and, except for
occasional pain on stooping, considered himself well.

The following cases are appended as of some general interest. The first
two (191, 192) illustrate extra-peritoneal injuries to the rectum. In
neither did positive evidence exist of wound of the bowel, but the
symptoms in each rendered this accident probable. Case 193 is an
illustration of apparent escape of the anal canal in a wound in which
from the position of the external apertures this escape would have
appeared impossible.

Wounds of the extra-peritoneal portion of the rectum, as a rule,
appeared to have a somewhat better prognosis than would have been
expected; in any case, the prognosis was far better than that obtaining
in wounds of the base of the urinary bladder. My experience on the
subject of these wounds was, however, limited to the two cases quoted.

Case 194 is inserted as an example of the complicated nature of the
abdominal injuries not so very unfrequently met with. It illustrates
well the difficulty which may arise at any stage in the course of
treatment of an injury, in the certain determination or exclusion of
wound of a part of the alimentary canal.

(191) Wounded at Magersfontein. _Entry_ (Mauser), in the right
loin, immediately below the ribs in the mid-axillary line;
_exit_, about the centre of the left buttock, on a level with
the tip of the great trochanter. A second lacerated shell wound
of back was present. All the wounds suppurated. For the first
sixteen days following the injury all control was lost over the
anal sphincter, and bloody faeces, and later slime, constantly
escaped, but no faecal matter ever escaped from the wound in the
buttock. There was no history of previous dysentery, and rectal
examination afforded no information. The buttock wound had to
be opened up, disclosing a tunnel in the ilium.

The wounds granulated slowly with continuous suppuration, but
were healed, and the patient returned home at the end of
fourteen weeks, the bowels acting normally.

(192) Wounded at Paardeberg. _Entry_ (Mauser), at the junction
of the middle and posterior thirds of the left iliac crest; the
bullet was retained, and removed (Mr. Pegg) from the back of
the right thigh, 3 inches below the back of the great
trochanter. After the injury retention of urine followed, with