Pamplona: A man was gored and six others taken to hospital on the fourth day of the annual San Fermin bull-running festival in the northern Spanish town of Pamplona, organisers said on Thursday.

The man gored in his right thigh was Spanish, aged 28. Doctors said his condition was under evaluation while he awaited surgery. Four of the men, including a 31-year-old American, suffered head injuries, and a Spaniard, 29, sustained multiple injuries. The rest were treated for cuts and bruises.

The American was injured while taking part in the early morning run ahead of bulls which career through the narrow, cobbled, Medieval streets of Pamplona and weigh up to 700 kilograms.

Thursday's  casualties add to dozens treated so far this week, including another American tourist who was gored on Wednesday, and serious injuries to other runners such as a collapsed lung, ruptured spleen and broken ribs.

A 23-year-old Irish tourist died on Sunday just ahead of the start of the festival after he fell from the old city walls.

Despite the crop of injuries, the centuries-old San Fermin festival draws tourists from around the world every year and each day's run, lasting about four minutes, is shown live on Spanish television. The bulls are usually killed after the runs by bullfighters.