intermediate marks to indicate its true track. Here, from the want of apparent connection between the two openings, the conclusion was at first come to that two projectiles had entered, one at the thigh, the other at the scrotum, and that both had lodged. Search was made for them, of course without effect. Subsequent events showed both wounds had been produced by one and the same bullet. The length of the traverse of a bullet, and the consequent distance between the openings of entrance and exit; the fact of parts of the body being brought into unusual relations with each other, due to peculiarities of posture at the time of being hit; or of a bullet being subjected to a special deflection after entering the body-all these circumstances have been sources of similar errors in the early diagnosis of cases.

A similar difficulty is not likely to be encountered with regard to wounds inflicted by narrow armoured projectiles. Their penetrative energy is so great, that when once they have entered the body they will almost certainly continue their course onward and make their escape. The occurrence of two of these projectiles penetrating the body of a soldier at the same instant, and lodging, will be scarcely possible. If the exact direction of the fire can be ascertained as well as the position of the wounded man at the time he was struck, the course of the projectile through the limb or body of a man will almost certainly be made clear, for the path of a small-bore rifle bullet is commonly most direct. It will then be sufficiently evident that the two wounds under observation are the openings of entrance and exit of one and the same projectile.

Single bullets sometimes make more than two openings.Surgeons were prepared in former days to find not unfrequently a greater number of openings, and more than one wounded track in the body, from a single bullet. This was liable to happen from several causes; and it might occur both from bullets that had remained entire, as well as from bullets that had been broken into two or more fragments.

Bullet remaining entire. With a bullet remaining entire, the number of wounds may be increased by the projectile traversing two or more adjoining parts of the same person. A soldier of the 55th Regiment was wounded in the Crimea by a musket bullet, which entered between the glans penis and prepuce, ran beneath the skin without opening the erectile tissue, made exit at the root of the penis, passed into and through the scrotum, entered the thigh, and, finally, was cut out of the buttock. Five apertures were here made by the bullet, without counting the one for its extraction. I have seen an officer in whose case a bullet passed through the forearm, arm, and side, making six openings in its passage. Here the forearm was bent upon the arm, which, again, was in close contact with the trunk, the

wounded parts being thus in close relationship with each other. Similar occurrences will take place occasionally with all bullets— with the recent small-bore projectiles as with others. By an accidental discharge in May 1892 of a Lee-Metford rifle in camp at Aldershot, a soldier sitting on a bench was wounded in one of his thighs by the bullet, which, after passing through the limb, entered the other thigh, severed the femoral artery, and caused the man's death through hæmorrhage. Such multiple wounds in contiguous parts of neighbouring limbs form complications that often affect to an important extent the prognosis in practice.

The explanation of the occurrence is not always so easy when several openings have been made by a single bullet and where the wounded parts are remote from each other. A few years ago a farmer's wife was fatally shot by a revolver. When seen, lying in bed, by a surgeon, four bullet openings were discovered-two in the right thigh, and two across the abdomen. The two wounds of the thigh were manifestly openings of entrance and exit, the two abdominal wounds were similarly related one to the other, and these facts, with the absence of all apparent uniformity in their direction as the woman lay in a horizontal posture, made them seem to have been caused by two distinct projectiles. They had, however, been caused by a single bullet, and the explanation was, that at the time the woman was shot she was in such a position that the surfaces of the thigh and abdomen were in direct apposition and actual contact. After death, on flexing the thigh upon the abdomen, and placing the wounded parts in the relations just mentioned, the continuity of the course of the bullet along the thigh and through the abdomen was at once rendered obvious. A case has been recorded in which a bullet struck the right arm above the elbow, causing a comminuted fracture of the humerus, and then entered the left arm below the elbow, fracturing the upper part of the radius. The bullet had passed in front of the man's trunk without touching it.

The occurrence of multiple wounds in neighbouring limbs or parts of a wounded man is analogous to the circumstance of a single bullet passing through several individuals in succession. Examples of such occurrences have been frequent since the introduction of rifled weapons. In the instance of the soldier just now mentioned who was wounded in both thighs by a Lee-Metford bullet, the projectile had previously passed through one of the thighs of another man who was sitting on the same form by his side; and, not improbably, had a dozen men been sitting in the direction of the path of the bullet, it would have equally passed through them all, such was its force and penetrative energy. The rifle had been fired by a cordite cartridge at a distance of only about 30 feet from the wounded men, but the bullet had passed

through two wooden doors before reaching them. Many instances of such multiple wounds from single bullets may be expected to occur in future wars.

Multiple wounds-bullet divided.—Leaden bullets, both soft and hardened, were subject to division into two or more portions on colliding with objects presenting sufficient resistance, and when the division occurred from the missile being split against a bone within the body, each fragment was liable to cause a wound in a different direction. In this way the division of a bullet might not only increase the number of wounds of exit contiguous to the part first wounded, but might also cause fresh wounds of entrance in some other adjoining part. A bullet has been known to enter the thigh on one side, to become split into two parts against the femur, and, after escaping from the inner aspect of the same thigh in two directions, to enter the corresponding face of the opposite thigh at two points-one ball thus causing five orifices, two of them being wounds of exit, and three being wounds of entrance. Similar effects might result from the bullet being divided by having come into collision with some narrow ridge of a superficial bone, or by its having been cleft against the sharp edge of a broken bone after it had been fractured by the projectile. Many examples have occurred of the division of leaden bullets into two or more parts, from having struck against the spine of the tibia, the supra-orbital ridge, the clavicles, or against edges of fractured cranium, lower maxilla, and other bones. This occurrence has even taken place from a leaden bullet impinging against the narrow margin of the semi-cartilaginous vomer. When such an accident took place, the divided parts of the bullet naturally diverged and pursued their courses in different directions, so that the instances of single projectiles leading to several wounded tracks within the body, and either causing lodgment of foreign bodies in different situations, or making several wounds of exit, were by no means uncommon in former wars. Multiple wounds from such causes are obviously not likely to occur in future with the small-bore rifle projectiles, in which the leaden portion is encased in a resisting armour of steel, nickel, or other hard metal.

Multiple wounds-more than one wound of entrance.-In the instances just mentioned the original opening was a single one, whatever might be the number of wounded tracks or openings afterwards effected; but sometimes even more than one original wound of entrance occurred, owing to some accident happening to a projectile just before striking the body. Soldiers have been wounded in several places from bullets having been divided into two or more portions by striking against a neighbouring rock or wall, or against stones on the ground a few paces in front of them, the fragments rebounding or glancing off at various angles, and

still preserving force enough to penetrate the men with whom they afterwards came into collision. This, again, is a class of injuries which is not likely to be very often met with when the narrow armoured projectiles are in general use in war.

Less wounds than projectiles. On the other hand, though happening more rarely, gunshot wounds in former days were occasionally less in number than the projectiles which had inflicted them. Several cases have come under my notice in past years among men invalided for the effects of gunshot wounds from whom two bullets had been extracted, though only one wound of entrance had been inflicted. The case of a gentleman who had been shot by a musket loaded with three bullets was recorded by John Hunter. In this instance there were only two orifices of entrance and two of exit, one ball having followed in the track of another; that there were three that went through him, was evident, for they afterwards made three holes in the wainscot behind him, but two were very near each other.' In the Pathological Museum at Netley there is a preparation of a femur taken from a soldier wounded in the Crimea, showing a fracture, the cure of which was prevented by the fact of two balls having entered by one wound, and the lodgment of the second at the seat of fracture having been undetected. With breech-loading rifles and special cartridges these accidents can hardly occur, but British soldiers have been exposed to be wounded by muzzle-loading arms for years, since the infantry of other European armies have had to encounter them in war. When muzzle-loading muskets were the weapons of our own troops, it frequently happened, under the excitement of action, that men, surrounded by the noise of musketry discharges, thought they had fired off their weapons when really they had not done Hence, double-loading was no uncommon occurrence, and the chance of more than one bullet entering by the same opening at short distances was proportionably greater. No doubt the same thing happens among the half-civilised and less perfectly equipped people in whose hands only muzzle-loading fire-arms are still found.

SO.

Even when bullets are fired from several distinct weapons, similar accidents may possibly occur. It is stated that in the case of a soldier who was shot for desertion and other crimes during the United States war of the rebellion, there were only eight entrance openings, although there was sufficient proof that ten bullets had passed through the prisoner's body. Four of the bullets must have passed through two of these openings.

CHAPTER II

CHARACTERISTIC FEATURES OF INJURIES FROM SUBSTANCES OF A GASEOUS FORM

Conditions which modify the characters of injuries from gases developed by explosion.-Gaseous substances, when they are urged forward with sudden violence, as occurs in explosions, act as veritable projectiles, and only differ from solid projectiles by their form of substance. The characters of bodily injuries produced by them, such as result from the ignition of gunpowder and the detonation of higher explosives, vary much more according to the manner in which the gas is directed against the body and the part of it which is struck, and these variations take place in a far more rapid ratio within limited distances, than do those of injuries produced by solid or liquid projectiles. This is manifestly due to the great rapidity with which such elastic substances quit the diminished volume under which they at first exist, and to the loss of elastic energy and propulsive force that takes place in proportion as the change is accomplished. The volume of gas resulting from the discharge of a blank cartridge from a weapon, the muzzle of which is placed in the mouth of a suicide, will tear the brain in pieces and separate all the bones of the cranium from its sutures; at the distance of a few yards the same discharge will inflict little more than a slight contusion; at a few yards farther off, nothing will be perceived but the impulse given to the surrounding air by it. The degree of severity of the injuries resulting from the gases produced by explosions, and the distances at which the injuries may be inflicted, greatly depend also upon the amount of gas evolved, or, in other words, the dimensions of the primary volume of gas, which constitutes the focus or centre of the sphere of destructive agency.

Wounds by gaseous projectiles. The impulsive force of discharged gaseous substances is manifested in the production not merely of contusions, but also of the severest wounds when circumstances are suitable. Such wounds usually exhibit a markedly lacerated and contused character, and are very irregular in outline. If clothes are worn over the wounded part, they are liable to be torn asunder, or may be so caught by the gas as to be carried away altogether—' blown off.'

Wounds from concentrated volumes of gas.-If a rifle be charged with gunpowder, and fired close to the head of a person, but yet in such a position that the bullet passes away without striking it, the surface near to which the muzzle of the fire-arm was placed will probably be found bared and the scalp irregu