Soothing applications appeared to be the best in the cases which I had an opportunity of watching. It is not easy to decide whether or not we should operate in such severe cases as sometimes occur, when half the foot, for example, or the lower part of the leg is implicated. Hither step is somewhat hopeless; but, if xirt be unquestionably dead, and of such a nature and size as not to be separable by " the parsimonious industry of nature," without so long a period of irritation and suppuration as will be, in all probability, fatal; or, if of a large gangrenous surface endangers nly the patient himself, but also his neighbours in or if there is hospital gangrene present in the hospital, to an attaek of which the long open state of his wound will so much expose him, then it is a fair question to consider, whether amputation is not a than waiting.
The success which follows, will nd much on the state of the patient's general health, and on the condition of the parts; as, unless a clear line of separation be formed, and the parts above be tolerably healthy, the irritation occasioned by removal will be sure to cause gangrene in tin stump at least so it was in the Eastern in all the eases in whieh I knew it 1 never heard of any amputation performed under the above circumstances succeed during the first winter, but several such occurred during the second. Operating at some distance beyond the spread of the disease, was generally found safer than at the place of division between the dead and living parts. Any wounds from frost-bite are peculiarly difficult to heal. i their effects for months after nd.
Thremoval of bone from the toes or fingers, howev. i black and apparently dead, and though "i.ly attached l.v the III,,M, Mimection, was certain to cause a 1:1 am..: whieh sometimes became in alarniinj-. Thi- n suit was probably as much due to the enfeebled state of the patient, as to the cause for which the operation was performed. Complete non-interference during every stage of treatment, the use of the mildest dressings, the removal of parts only when quite disjoined, proved the best line of procedure. I never saw any other followed, either in our hospitals or in those of the French, without there being ample cause to regret it. Any roughness even, in dressing these injuries, endangered the appearance of gangrene, on the verge of which they always seemed to hover.