I am aware, and have short details of the histories of eight patients wounded in the same battles who died prior to the termination of the first thirty-six hours; but these are not included, for the reason stated above, and also because I am uncertain whether all the injuries were produced by bullets of small calibre.
| Viscous wounded | Number of cases | Localised Secondary suppuration occurred | Recovered | Died |
| Stomach certain | 2 | — | 1 | 1 |
| Stomach possible | 1 | — | 1 | — |
| Small intestine certain | 5 | 0 | — | 5 |
| Small intestine possible | 10 | 0 | 10 | — |
| Large intestine certain | 8 | 4[21] | 4 | 4 |
| Large intestine possible | 4 | — | 4 | — |
| Bladder certain | 3 | 3 | 1 | 2 |
| Bladder possible | 1 | — | 1 | — |
| Liver | 6 | — | 6 | — |
| Kidneys | 6 | — | 4 | 2 |
| Spleen | 3 | — | 2 | 1 |
| Total | 49[22] | — | 34 | 15 |
Included in the above table are thirty instances of intestinal injury, and these are divided up according to the segment of the intestinal canal implicated, and also as to whether the perforation was certain, or only assumed from the position of the external apertures and the presence of abdominal symptoms of a noticeable grade.
From this analysis it appears clear—
1. That wounds of the stomach have a comparatively good prognosis, and that they may recover spontaneously. It is true that only two examples are included in my table; but I was at various times shown patients with similar injuries and histories, and a number of cases which have been published appear to substantiate the opinion. From our experience of the occasional spontaneous recovery of gastric perforations from disease, I think we might be prepared to expect that the stomach would offer a comparatively favourable seat for these wounds. It may be pointed out, however, that hæmatemesis, the main feature in the symptoms pointing to wound, is by no means direct proof of more than contusion.
2. That perforating wounds of the small intestine are very fatal injuries; every patient in whom the condition was certainly diagnosed died.
3. That in the cases in which a perforation was inferred from the position of the external apertures and the symptoms, not one patient suffered from the secondary complications—e.g. local peritonitis and suppuration, which were common in the case of the large intestine, and which we are accustomed to see after perforation from disease. This renders the occurrence of actual perforation in the majority of the cases a matter of very grave doubt.
If spontaneous recovery does take place after this injury, it is only in cases in which the wounds are single, and slight in character.
4. That in eight cases in which perforation of the large intestine was certain, four recoveries took place; but in each instance suppuration occurred. I am, however, quite prepared to believe that perforation may have occurred in some or all of the other four cases included as 'possible,' provided the wounds were intra-peritoneal.
Wounds of the cæcum and ascending colon are those which have the best prognosis, and after these of the rectum. The comparatively good prognosis in these parts is what would be expected, on account of their greater fixity, and lesser tendency to be covered by the small intestine.