to in the text was discharged from the service at Chatham on December 20, 1855, all his wounds being then healed.

Multiple amputations from gunshot wounds, note 36, p. 246.

'What we observed at the Seat of War in 1870,' by C. Orton and W. D. Spanton, London, 1871, p. 11.

SECTION V

AIDS TO DIAGNOSIS OF GUNSHOT INJURIES

Evidence furnished by clothes, note 1, p. 250.

'A Treatise on Gunshot Wounds, &c.,' by G. T. Guthrie, London, 1820, p. 20; Hennen, 'Prin. of Mil. Surgery,' London, 1829, p. 36; Jobert De Lamballe, Plaies d'Armes à Feu, Paris, 1833, p. 32.

Clothes proving wound to have been self-inflicted, note 2, p. 251.

Marshall, 'On the Enlisting, Discharging, and Pensioning of Soldiers,' Edinburgh, 1839, p. 141.

Evidence furnished by a single hair, note 3, p. 257.

For a complete history of this case, see Amer. Journal of the Med. Sciences, vol. cxxiv., October 1871, p. 385.

Evidence furnished by projectiles, note 4, p. 259.

'Cat. of Museum of Mil. Surgery, Netley,' Appendix, Spec. No. 609c.

Vertebral injury demonstrated by a bullet, note 5, p. 261.

For a full history of this case, see the Lancet, vol. i. for 1855, p. 607; and 'Guy's Hosp. Reports,' 3rd Series, vol. v., 1859, p. 173.

SECTION VI

SECONDARY COMPLICATIONS OF GUNSHOT INJURIES

Gangrene from cold during the Crimean war, note 1, p. 274.

For a very complete and excellent account of the gangrene of combined cold and bodily debility as they occurred among the British troops in the Crimea, see the summary of Dr. Hanbury in the 2nd volume of the Official Medical and Surgical History of the War, sect. viii. p. 187 to p. 193; see also Return A. in the same volume, p. 251, showing the monthly admissions into hospital, and deaths, from disease and injury in the army of the East.

Gangrene after shot wounds in the U. S. civil war, note 2, p. 274.

See the Surg. History of the War, part iii. pp. 825.

Suddenly developed general gangrene, note 3, p. 276.

'Report on the Pathology of the Diseases of the Army in the East,' London, 1856, p. 105. Dr. Lyons was sent by Lord Panmure, in April 1855, to conduct pathological researches in the hospitals of the army in the East. Dr. Lyons' researches were chiefly pursued in the Crimea, while Dr. Aitken, who was with him as first assistant, conducted the investigations at Scutari.

Gangrene in Crimean hospitals, note 4, p. 276.

See Report by Dr. Lyons, above named, p. 275.

Rapidly destructive gangrene in war hospitals, note 5, p. 278.

Prof. Delorme of Paris, who describes this form of gangrene under the name of 'Gangrène gazeuse foudroyante,' states that it has claimed many victims among the wounded in field and fixed army hospitals since the Crimean war. He refers to the descriptions by Dr. Salleron of it as it appeared epidemically among the wounded in the crowded hospitals on the Bosphorus, by Dr. Chenu as witnessed in the Italian campaign of 1859, and Franco-German war of 1870-71, and by other observers who saw it during the reign of the Commune at Paris.-Traité de Chirurgie de Guerre, par E. Delorme, Paris, 1888, tome i. p. 579.

Varieties of secondary hemorrhage, note 6, p. 282.

'Reports of Observations in the Brit. Mil. Hospitals in Belgium,' &c., by J. Thomson, &c., Edinburgh, 1816, p. 47.

6

Periods of secondary hæmorrhage, note 7, p. 282.

Guthrie, Commentaries on the Surgery of the War in Portugal,' &c., London, 1853, p. 203.

Hospital gangrene in the Peninsular war, note 8, p. 287.

'Commentaries on the Surgery of the War in Portugal,' &c., by G. T. Guthrie, F.R.S., London, 1853, p. 169.

Hospital gangrene in the Sikh war, note 9, p. 287.

Guthrie, op. cit., p. 165.

Hospital gangrene in French army hospitals, note 10, p. 289. Traité de Chirurgie d'Armée, par L. Legouest, Paris, 1872, p. 650.

Hospital gangrene in India, note 11, p. 290.

'Madras Quarterly Journal of Medical Science,' July 1, 1860, p. 22, &c.

Hennen's Obs. on hospital gangrene, note 12, p. 290.

'Principles of Military Surgery,' by John Hennen, M.D., London, 1829, pp. 217-20.

Blackadder's views on hospital gangrene, note 13, p. 291.

'Observations on Phagedæna Gangrænosa,' by H. Home Blackadder, Edinburgh, 1818, p. 39. ;

Guthrie on hospital gangrene, note 14,

Guthrie, op. cit., p. 158.

p. 293.

Infectious nature of hospital gangrene, note 15, p. 294.

See Blackadder, op. cit., p. 43; and Legouest, op. cit., p. 651.

Hospital gangrene communicated by sponges, note 16, p. 295.

'A System of Surgery,' &c., edited by Holmes, London, 1870, vol. i. p. 164.

Hospital gangrene communicated by attendants, note 17, p. 295.

Mr. Barker's paper is published in the Medical Press and Circular of March 19, 1873, p. 243.

Hospital gangrene communicated by foul air, note 18, p. 295.

Hennen, op. cit., p. 235.

Hospital gangrene not produced without direct contact, note 19, p. 296. Blackadder, op. cit., pp. 46, 47.

Hospital gangrene in United States civil war, note 20, p. 296.

Surgical History of the War, op. cit., part iii. p. 833, &c.

Conditions favouring the spread of hospital gangrene, note 21, p. 297. Consult Hennen, op. cit., p. 241, and other observers on this subject.

Influence of mental depression on spread of hospital gangrene, note 22, p. 298. 'Surgical History of United States War,' op. cit., part iii. p. 830.

Hunter on pyæmia, note 23, p. 299.

'Very strange instances of translation are given to us; it has been supposed that pus already formed has been translated to another part of the body, deposited there in the form of an abscess, and then discharged. This is absolutely impossible.'-The Works of John Hunter, edited by Palmer, London, 1837, vol. iii. p. 395.

Tetanus in the West Indies, note 24, P. 310.

'Obs. on the Dis. of Seamen,' by Gilbert Blane, M.D., London, 1789, p. 519. From the account given, it appears 810 men were wounded in the actions of April 1782, of whom 266 were killed outright, 67 died of their wounds on board, and 21 in hospital on shore.

Tetanus during the Peninsular war, note 25, p. 310.

'Medico-Chirurgical Trans.,' vol. vi. p. 449.

Relative number of cases of tetanus in former wars, note 26, p. 310. Ballingall's 'Outlines of Military Surgery,' Edinburgh, 1838, p. 257.

Absence of tetanus at Paris in 1848, note 27, p. 310.

Communication de M. Roux à l'Académie Nat. de Méd.; Séance de 1er Août

1848.

Tetanus in Crimean war among British wounded, note 28, p. 310.

Official Surgical History, p. 284. Two other cases occurred in the field —one after frost-bite, the other probably idiopathic. There were five cases at Scutari during the winter of 1854-55-three among wounded from the Crimea, one in a patient suffering from dysentery and frost-bite, and one idiopathic. A sixth case occurred in England; it followed amputation for diseased bone consequent on frost-bite in a Crimean invalid. There were thus twenty-nine cases of tetanus from all causes among the officers and men who were engaged in the military operations against Russia in 1854-56.

Tetanus in Crimean war among French wounded, note 29, p. 310.

Relation Med. Chir. de la Campagne d'Orient, par le Dr. G. Scrive, Paris, 1857, pp. 349, 448, and 460. Dr. Chenu has not given a table of cases of tetanus in his History of the Crimean War.'

Tetanus in Crimean war among Russian wounded, note 30, p. 311. Kriegschirurgie, N. Pirogoff, p. 928.

Tetanus in the Italian war of 1859, note 31,

p. 311.

Campagne d'Italie, par le Dr. Chenu, Paris, 1869, tome ii. p. 396. Numerous reports on tetanus by French surgeons, as observed in the Italian war, with illustrative cases of much interest, are quoted by Dr. Chenu. See also Dr. Demme, Algemeine Chir. der Kriegswunden in den Norditalienischen Hospitülern von 1859. Würzburg, 1861, pp. 146-56, and Appendix, p. 283.

Tetanus during United States civil war, note 32, p. 311.

'Med. and Surg. Hist. of the War of the Rebellion; 'Surg. Hist., part iii. vol. ii. p. 818.

Tetanus in war of Indian Mutiny, note 33, p. 312.

'Notes on the Surgery of the Indian Campaign of 1857-58,' by J. Brown, M.D., Bengal Med. Service, in the Indian Lancet, 15th December, 1860, p. 376.

Tetanus and lodgment of cloth, note 34, p. 314.

Recueil de Mém. de Méd. et Chir. Mil., tome v., 1861, p. 392.

Nerve lesions and tetanus, note 35, p. 315.

'Med. Chir. Trans.,' vol. iv. p. 48. Case of wound of the radial nerve.'

Lesions of cutaneous nerves, note 36, p. 315.

'Injuries of Nerves,' by S. Weir-Mitchell, M.D., Phil., 1872, p. 147.

Atmospheric changes and tetanus, note 37, p. 316.

Mém. de Chir. Mil., &c., par D. J. Larrey, Paris, 1812, tome iii. p. 286 and p. 292.

Effects of damp in producing tetanus, note 38, p. 316.

Circ. No. vi., W. D., Surgeon-General's Office, Washington, 1st Nov. 1865.

Tetanus at Strasburg in 1870, note 39, p. 316.

Guerre de 1870-71, Chenu, tome i. pp. 476-78.

Changes of temperature with damp, note 40, p. 316.

Hammond, 'Diseases of the Nervous System,' New York, 1871, p. 534.

The bacillus tetani, note 41, p. 318.

A summary of the investigations regarding the so-called bacillus tetani may be seen in Dr. C. Flügge's work on 'Micro-organisms, with special reference to the Etiology of the Infective Diseases, translated by Dr. W. W. Cheyne, and published by the New Sydenham Society. (See vol. 132, London, 1890, pp. 240-43.)

The following are the chief facts contained in it. Nicolaier, of the Göttingen Hygienic Laboratory, found that, when certain kinds of garden earth was introduced under the skin of mice and rabbits, the usual symptoms of tetanus were caused, and death followed, in the mice, on an average at the end of three days, and in the rabbits, from the fifth to the seventh day, after inoculation. In the pus at the seat of inoculation fine bacilli were constantly present. These bacilli could not be directly demonstrated in the garden earth itself. When specimens of the earth were heated to (190° C., 374° F.) they produced no effect though introduced in larger quantity. The inference was that the micro-organisms were destroyed by the heat to which the earth had been subjected. The tetanus could be transmitted from animal to animal by inoculation with small quantities of pus from the diseased animal. Two Italian observers removed some tissue from the seat of infection of a patient who had died of tetanus, and injected