riginal entry wound was enlarged, and a catheter
was tied into the bladder. Little change occurred in the
symptoms and the local condition, urine and pus continued to
escape freely from the posterior wound, and the patient
gradually sank, dying on the thirty-eighth day. At the
_post-mortem_ examination the peritoneum was found intact and
unaltered, but there was extensive pelvic cellulitis around the
bladder, a large slough and some pus lying in the cavum Retzii.
An aperture of entry still open existed in the centre of the
anterior wall of the bladder, and a patent exit opening at the
base of the trigone. The bullet had passed out of the pelvis by
the great sciatic notch.

The above remarks and cases sufficiently set forth the prognosis in
these injuries. For the intra-peritoneal lesions an expectant plan of
treatment may be followed by uncomplicated recovery. Mention has already
been made of a case in which a Mauser bullet was retained in the bladder
and was subsequently passed per urethram. In such a case a cystotomy
would be indicated were the bullet discovered in the viscus.

As to extra-peritoneal injuries it is difficult to lay down guiding
lines. I believe the ideal treatment would be a supra-pubic cystotomy
and drainage of the bladder by a Sprengel's pump apparatus, such as we
employ at home. Under these circumstances, with the possibility of
keeping the bladder actually empty, I believe good results might be
obtained. Certainly drainage of the bladder by a catheter tied in proved
worse than useless, and I very much doubt whether a simple supra-pubic
opening would give any better results under the circumstances under
which a patient has to be treated in a Field hospital.

Cases might, however, occur in which oblique passage of the bullet cuts
a groove and makes a large opening in the peritoneum-clad portion of the
viscus. Under satisfactory conditions a laparotomy would be here
indicated. I take it that this condition would most probably be
accompanied by retention of bloody urine, which fact would arouse
suspicion.

INJURIES TO THE SOLID ABDOMINAL VISCERA

_Wounds of the kidney._--Tracks implicating the kidneys were of
comparatively common occurrence. As uncomplicated injuries they healed
rapidly, and without producing any serious symptoms beyond transient
haematuria.

The nature of the lesion appeared to vary with the direction of the
wound. In m