Produced by Jonathan Ingram, Josephine Paolucci and the Online Distributed Proofreading Team at https://www.pgdp.net [Illustration: FRONTISPIECE. Photo, H. KISCH Ladysmith. Engraved and Printed by Bale and Danielsson, Ltd.] SURGICAL EXPERIENCES IN SOUTH AFRICA 1899-1900 BEING MAINLY A CLINICAL STUDY OF THE NATURE AND EFFECTS OF INJURIES PRODUCED BY BULLETS OF SMALL CALIBRE BY GEORGE HENRY MAKINS, F.R.C.S. SURGEON TO ST. THOMAS'S HOSPITAL, LONDON JOINT LECTURER ON SURGERY IN THE MEDICAL SCHOOL OF ST. THOMAS'S HOSPITAL MEMBER OF THE COURT OF EXAMINERS OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND, AND LATE ONE OF THE CONSULTING SURGEONS TO THE SOUTH AFRICAN FIELD FORCE LONDON SMITH, ELDER, & CO., 15 WATERLOO PLACE 1901 TO SURGEON-GENERAL W. D. WILSON PRINCIPAL MEDICAL OFFICER TO THE SOUTH AFRICAN FIELD FORCE THE MEMBERS OF THE ROYAL ARMY MEDICAL CORPS EMPLOYED IN SOUTH AFRICA AND TO THE CIVIL SURGEONS TEMPORARILY ATTACHED TO THAT CORPS These Experiences are Dedicated AS AN EXPRESSION OF APPRECIATION OF THE INVARIABLE KINDNESS AND SYMPATHY EXTENDED TO THE AUTHOR WITHOUT WHICH THE BOOK COULD NOT HAVE BEEN WRITTEN PREFACE A word of explanation is perhaps necessary as to the form in which these experiences have been put together. The matter was originally collected with the object of sending a series of articles to the _British Medical Journal_. Various circumstances, however, of which the chief was the feeling that extending experience altered in many cases the views adopted at first sight, prevented the original intention from being carried into execution, and the articles, considerably expanded, are now published together. As to the illustrative cases introduced in support of various statements made in the text, only those have been chosen from my notes which were under my own observation for a considerable time, and many of these have been brought up to date since my return to England. I have, as a rule, avoided the inclusion of cases seen cursorily, and few simple ones have been quoted since their character is sufficiently indicated in the text. These remarks seem necessary since the mode of selection has resulted in the inclusion of a number of cases of exceptional severity, and any attempt to draw statistical conclusions from them would be most misleading. The first two chapters have been added with a view to affording some information, first, as to the conditions under which a great part of the surgical work was done, and, secondly, as to the mechanism and causation of the injuries, which would not readily be at hand in the case of the general surgical reader. For much of the information contained in Chapter II. I must express my indebtedness to the work of MM. Nimier and Laval, so frequently quoted.