order to get suitable covering for the stump. In the instance of Captain K., the leg was not taken completely off, but it was only hanging by the skin of the back of the popliteal space, on which the bones forming the knee-joint were lying pulverised. On the occasion of the final assault of Sebastopol, three men of the 19th Regiment were moving along one of the trenches close to one another, when a heavy projectile, sweeping along, carried off the right arms of the first and second men in advance, and smashed the right arm of the third man behind. Amputation was required in the first two instances only to get coverings for the stumps; in the third, to remove the parts which had been shattered. Among the large coloured drawings by Sir Charles Bell at Netley are three of soldiers whose arms had been completely carried away, in two instances by cannon balls, in the third by a howitzer shell, at the battle of Waterloo The head of the humerus is shown in one case remaining entire in the socket without fissures, while the surface of the soft parts left by the shot is very nearly level.

Instances of rifle bullets at muzzle speed failing to perforate the cranium,

note 12, p. 144.

The following are short descriptions of the preparations representing the three cases of suicide alluded to in the text, in each of which a rifle bullet was fired, with a full charge of powder, directly into the head, without effecting a passage through it.

1. No. 606A, Museum of Military Surgery, Netley-case containing twelve fragments of a leaden bullet and wooden plug, together with the remains of the Snider-Enfield cartridge out of which the bullet was fired. No. 485, App. Pathological Museum, Netley-fractured bones of cranium, and upper five cervical vertebræ, articulated as far as practicable, together with broken remains of facial bones strung on wire. From Private J. P., 1st Battalion, 11th Regiment, who committed suicide at Morar, Central India, in July 1872, by placing the muzzle of a breech-loading Enfield rifle in his mouth and pulling the trigger with his foot. The scalp was not perforated. The skull could be felt to be shattered on pressing the scalp. On examination, the tongue presented a V-shaped laceration and was much charred. Several of the cervical vertebræ were fractured, the atlas and axis being partly pulverised. Nearly all the bones of the face and cranium were more or less shattered. In some places brain substance was forced between the clefts of the broken bones. Brain mashed up, and detached pieces of bone in it. The wooden plug of the bullet was found in the substance of the trapezius m. on a line with the broken axis. The clay plug was not discovered. The history of the case, and the preparations which accompanied it, were presented by Staff Assistant-Surgeon J. B. Wilson, M.D.

2. No. 605, Museum of Military Surgery-case containing nine fragments, of different sizes, all more or less flattened and distorted, of a Snider-Enfield bullet, and the wooden plug, together with the cartridge case removed from the rifle. Private W. W., æt. 21, 1st Battalion, Coldstream Guards, committed suicide at Brompton barracks, on January 28, 1872. These specimens, with a history of the case, were forwarded by Staff AssistantSurgeon Allen, M.D., who made the post-mortem examination. The man had placed the muzzle of his rifle under his chin, and discharged its contents by means of a piece of braid attached to the trigger. The scalp was found to be entire. There were two projections over the occipital bone, one on each side of the occipital protuberance. One appeared to be the conical bullet, but on inspection was found to consist of pulverised bone, which a portion of the bullet had driven out through a clean circular aperture. The other projection was caused by some fragments of the bullet. All the larger eranial bones were separated at their sutures; fragments of lead were scattered among them.

3. No. 605A, Museum of Military Surgery--greatly distorted SniderEnfield rifle bullet and wooden plug, removed from the posterior lobe of the left hemisphere of the brain of Private R. S., 2-16th Regiment. Presented by Surgeon R. M. Bradford, who made the post-mortem examination. The man was found dead on the floor of his hut on the 8th December 1869, with his rifle between his knees, and the boot and stocking removed from his left foot. There was a small circular hole, with slightly inverted edges, beneath his chin, and the surrounding skin for more than an inch in every direction was blackened and burned. No orifice detected by which the bullet could have escaped. Large quantity of blood about the ears and nose. On removing the scalp, the vault of the cranium was found broken into many irregular pieces. Great extravasation of blood between the skull and surface of the brain. Brain entirely broken up, blackened, with strong odour of exploded gunpowder, and containing many small fragments of bone. On removing the brain the bullet fell out on the table. It was flattened into an irregular crescentic shape, much indented, and from its position seemed to have been stopped and altered in shape by the occipital bone, which, however, was not itself broken. The base of the skull was shattered into a multitude of fragments, none of the bones being distinguishable. The rifle used was the Snider-Enfield, with the regulation cartridge.

Enlargement of exit wound of bullet, note 13, p. 148.

Preparation No. 510, Pathological Museum, Netley.

Fatal wound of President Lincoln, note 14, p. 153.

Observations on special features of this wound will be found in the 'Surgical History of the U. S. War of the Rebellion,' Part i., 'Wounds of the Head,' p. 306. See also the Lancet, vol. i., 1865, p. 649.

Bone fractures by small-bore bullets, note 14*, p. 159.

The principal works in which drawings and photographic plates to illustrate the effects of small-bore rifle bullets fired against bones at different distances may be seen, are the following:

Etudes Experimentales sur l'Action du Projectile Cuirassé du Fusil Mannlicher, nouveau modèle Roumain. de 65 mm., par le Dr. A. Demosthen, &c., Bucarest, F. Göbl Fils, 1894. Captain Lagarde, 'Report of a Series of Expts. conducted at Frankfort Arsenal, in connection with the Ordnance Dept. of the U. S. Army,' printed in the Report of the Surgeon-General of the Army to the Secretary for War, for the fiscal year 1893, Washington, Government Printing Office, 1893, p. 73 to p. 95. Habart, Die Geschoss-wirkung der 8 mm. Handfeuerwaffen an Meuschen und Pferden, 1892. GeneralStabsarzt Prof. Dr. von Coler, und Stabsarzt Dr. Scherning, Ueber die Wirkung und die Kriegschirurgische Bedentung der neuen Handfeuerwaffen; Atlas; 17 Tafeln en Photogravüre; Berlin, Hirschwald, 1894.

Rasing shot, note 15, p. 110.

From the French raser, to shave. La balle lui rasa le bras:''the bullet scored his arm.' It is in common use as a military term; thus, Rasing fire, the fire from the rasant flank of a bastion. It is sometimes written ‘grazing," but is properly as above.

Wound from a descending ricochet bullet, note 16, p. 162.

Captain G. Egerton, D.I.M., in the course of a lecture on Rifle Ranges, in February 1892, mentioned a case in which a bullet ricochetted from the ground and mounted very high into the air. In descending it wounded a marker in the head. The man was sitting on the ground with his back against a 30-ft. wall just to the left of the target which was being fired at.

Gaseous projectiles, note 17, p. 169.

'Erichsen's Surgery,' 6th edition, vol. i. p. 162.

Gaseous projectiles, note 18, p. 169.

Army Medical Reports, vol. viii. p. 521.

Note 19, p. 171.-Surgical History of the Crimean War,' p. 310.

Note 20, p. 171.-'Notes of an Ambulance Surgeon,' by Sir William MacCormac, London, 1871, p. 49.

Note 21, p. 171.-'Dr. Roberts' Report of the 4th Divn., &c.'-Med. Times and Gazette, February 23, 1856, p. 184.

Magazine Explosions, note 22, p. 172.

Campagne d'Orient en 1854-56, par J. C. Chenu, &c., &c., Paris, 1865,

p. 118.

Note 23, p. 172.-The quantity of gunpowder exploded, and the number of casualties on the French side, were given at much higher figures at the time of the occurrence of the accident. Mr. Russell states in his 'Diary' that the quantity of gunpowder blown up in the French Parc de Siège was: Russian powder, about 1700 barrels: French powder, about 800 barrels; or a total of about 250,000 lbs., irrespective of that contained in shells, rockets, and small-arm ammunition. He also relates that the French had 6 officers killed and 13 wounded; 65 men, chiefly artillerymen, killed, and 170 wounded. The effects of this explosion are very graphically described by Mr. Russell (see 'The War, from the Death of Lord Raglan to the Evacuation of the Crimea,' by W. H. Russell, London, 1856, p. 350, &c.).

Note 24, p. 172.-See Genl. Codrington's Despatch to Lord Panmure, dated November 17, 1855, and Adjt.-Genl. Pakenham's Returns enclosed. The force of the atmospheric wave from the explosion is well illustrated by the fact incidentally mentioned by Genl. Codrington, that windows were burst open and broken at the farm-house where the headquarters were established. This building was distant two and a half miles from the place where the explosion occurred.

Slit-like tracks of bullets, note 25, p. 179.

Legouest, Traité de Chirurgie d'Armée, Paris, 1863, p. 339.

Removal of substance in bullet tracks, note 26, p. 184.

'A Treatise on Gunshot Wounds,' by G. T. Guthrie, &c., London, 1820,

p. 27.

Tracks left by explosive bullets, note 27, p. 188.

Relation Med. Chir. de la Campagne d'Orient, par le Dr. J. Scrive, Médecin-en-chef de l'Armée, &c., Paris, 1857, p. 438.

American explosive bullets, note 28, p. 188.

Specimens Nos. 4601 and 4621 in the Washington Museum.

Fire of explosive bullets, note 29, p. 188.

'Memoirs of the Confederate War of Independence,' by Heros von Borcke, Chief of Staff to Genl. Stuart, in Blackwood's Magazine for Oct. 1865, p. 406.

Supposed shell bullet from wound of thigh, note 30, p. 189.

Specimen No. 4561 in the Washington Museum is the explosive projectile referred to. It is labelled, 'A conoidal bullet, considered to be a specimen of the explosive ball.' Fig. 30 is copied from a drawing of this specimen. I have frequently seen a conoidal bullet, with an iron culot, assume a similar shape when it has happened that the iron cup (not a very rare occurrence with the Minié bullet) had been driven through the projectile at the time of its discharge from the rifle.

Fosbery's shell bullets, note 31, p. 189.

See the Journal of the Royal U. S. Institution,' vol. xii., London, 1869, p. 16, art. 'Explosive Bullets and their Application to Military Purposes.'

Wounds from explosive bullets in India, note 32, p. 189.

6

See a letter in the Times signed Marksman,' and dated December 10, 1868. The writer concludes that explosive bullets only cause useless mutilation, though for certain military purposes they might occasionally be employed with considerable advantage.

Wounds by small shot, note 33, p. 191.

I made a series of experiments with a breech-loading fowling-piece, using one of Eley's cartridges with No. 16 shot, about 250 in a charge, and, comparing them with the well-known experiments recorded by Dr. Lachèse, found the range at which the effects described by him were produced in all instances considerably extended. Thus Dr. Lachèse records that at a distance of 3 feet there was no longer any central opening from the shot; while in my trial of 15 feet there was still a central hole 14" x 4" in size, with scalloped edges and an irregular outline. About 100 shot had passed through this opening. Outside the central hole there were about 140 shot openings; some having passed singly, in other instances two side by side, in others three or more together, in others the shot combining to form an irregular rent, and all these being within a circle of about 7 inches in diameter. At 50 yards about 150 shot out of the 250 pierced a wooden target 8 feet high by 6 feet wide, generally penetrating the wood to their own depth. They were very widely scattered over the target, from top to bottom. The experiments of Dr. Lachèse showed great scattering of the shot at very short distances compared with the distances just mentioned.-See Obss, et Expériences sur les Plaies produites par des Coups de Fusil Chargés à Poudre ou à Plomb, &c., par le Dr. Lachèse Fils: Annales d'Hygiène Publique, tome xv., 1836, p. 359.

SECTION IV

PRIMARY SYMPTOMS AND COMPLICATIONS OF GUNSHOT

INJURIES

Pain of gunshot wounds of bones, note 1, p. 199.

Dr. Chenu mentions the case of an artilleryman in the Italian campaign of 1859 who had the neck of his left thigh-bone fractured by a bullet while he was loading his gun. The man, who had his leg advanced at the time, went on with what he was about, unconscious of what had happened, though conscious of a severe general shock; but on presently making an effort to draw himself upright, he tottered, and only avoided falling by supporting himself against a tree (Campagne d'Italie, tome ii. p. 290). He has also related the case of a mounted officer who had the neck of the thigh-bone broken by a bullet in the Franco-German war. Although sensible of a dull blow, he had no conception of the severe injury that had happened to him until he saw his limb drop from the stirrup, and found himself unable to replace it there (Guerre de 1870-71, tome i., intro. p. 31).

Sir C. Napier's shell wound, note 2, p. 201.

'Life of Sir Charles Napier,' vol. ii. p. 193. Diary.

Signs of pain exhibited by patients, note 3, p. 201.

When acting as Mr. Bransby Cooper's dresser at Guy's Hospital, I assisted at the case of a man who, while the knife was in the act of amputating his arm, laughed at the pale faces and general aspects of some of the students on the benches of the theatre above, who were probably seeing such an operation for the first time. This was, of course, before the days of anæsthetics. On the other hand, I knew an officer of standing in the army, a captain, who received a bullet wound of only a finger at the battle of the Alma, and who went about uttering such exclamations concerning the pain caused by it, and continued evincing such excitement, losing all rational control over himself, that his condition resembled that of a patient suffering from delirium.

Pain along bullet tracks, note 4, p. 203.

Extract from 'Life in India and Scenes in the Mutiny,' a lecture delivered in Halifax in 1860, by H. Chalmers-Miles, Assist.-Surgeon R.A., Halifax, N.S., 1860, p. 15.

6

Special sensory effects, note 5, p. 204.

Injuries of Nerves, &c.,' by S. Weir-Mitchell, M.D., Phil., 1872, p. 146.

Hæmorrhage after gunshot wounds, note 6, p. 212.

It appears that death from hæmorrhage may sometimes be prevented without any material contraction of the arterial tube, and by quite a different process from that described in the text. Dr. Chenu has reported