n, and nearly to the median
line. This gradually increased until it filled half the belly;
it was at first thought to be a retro-peritoneal haematoma
(similar to that described in case 194), but it became quite
soft and fluctuating, and was then tapped, and [Symbol:
ounce]50 of blood-stained fluid, which proved to be urine, were
removed. The urine rapidly reaccumulated, and the cavity was
then laid freely open. Urine continued to discharge in large
quantity for two months, the man meanwhile remaining well, and
passing a somewhat variable daily quantity of urine ([Symbol:
ounce]xxiv-[Symbol: ounce]lx).

At the end of six months the wound had healed, and the man was
serving as an orderly in the hospital.

(203) _Wound of right kidney and lung._--Wounded near
Paardekraal, while crawling on hands and knees. _Entry_
(Martini-Henry, or small bullet making lateral impact), just
above the right nipple, opening ragged and large, bullet
retained. There was very severe shock, accompanied by vomiting,
but no haematemesis. Later there was some haemoptysis. Pulse 120,
respirations 48.

Twenty-four hours later the vomiting had ceased; the patient
had passed a restless night, in spite of an injection of
morphia. He lay on his right side, pale and collapsed, but
answered questions and was quite collected. Pulse
imperceptible, respirations 56; the abdomen moved freely. The
urine had been passed twice, and was chiefly blood. The patient
died shortly afterwards, apparently mainly from internal
haemorrhage, although restlessness was not a prominent feature.
As the Column was on the march no autopsy was possible.

The treatment of uncomplicated wounds of the kidney consisted in the
ensurance of rest, either alone, or with the administration of opium if
the haematuria was severe. The after-treatment in the event of the
development of hydronephrosis is on ordinary lines. Tapping, or incision
followed by extirpation of the injured viscus, if the less severe
procedures failed. I never saw a case where renal haemorrhage suggested
the removal of the kidney as a primary step, and much doubt whether such
a case is likely to be met with, as the result of a wound from a bullet
of small calibre.

_Wounds of the liver._--Wounds of the liver were, I believe, responsible
for more cases of death from primary hae