Another case was that of a soldier of the 62nd, who was found a day or two alter bring wounded, lying in the dockyard stores of Sebastopol, under the charge of the Russian surgeons. He was discovered when the place was evacuated, and carried to his regimental hospital, where he recovered. The fracture in this case was in the lower part of the upper third. It had been occasioned by a round ball. and the splintering was not great. This man, however, in the best health when hit. lie had just joined from Kngland, and his injury was comparatively slight. The third man may be said to have had his limb consoli!. in so far as that a mass of callus was thrown out. which ceiiH bone; but he died of purulent poisoning, and never left the Crimea.
1 could not iind out whether it was a round or a conical ball which caused the fracture in this case. I know that the French had hardly any iv. ( hie was. however, presented l,y the I to th.Boeietfc de Chininrie last May. Thi I often examined at Constantinople. This man's thigh was quite firm, and liad been allowed to unite almost without treatment. There were probably a few other cases, but they did not fall under my notiee; although during constant wanderings through the hospitals in front and on the Bosphorus, I was unremitting in my inquiries after such cases.
I am certain, however, that, although the instances of recoveries were rare, they were yet not so exceptional as recoveries after amputation at the same part, as will be afterwards more particularly dwelt upon; and thus it would appear that, so far as the experience of this war is concerned, we must conclude, that slight as the chance of saving life is in any case, it is still our part to attempt consolidation in preference to the fracture is in the upper third of the bone. M. Simon of Geissen draws a like conclusion from a review of all the reported cases of the injury; but he extends the doctrine to the middle third, in which I cannot agree with him, for reasons which I will afterwards state.
In the Schleswic-Holstein war, they preferred to preservation in such cases. M. Hutin. in the Invalides, was able to discover twenty-four cases of recovery after thigh, but no case of recovery after amputation in the same part. This goes further to prove the position maintained above. In whatever way we decide, it is unfortunately too true that death will most commonly follow; but yet, when we do not operate, the patient may live in comparative comfort for several weeks, while, in the other case, he has to undergo a very fearful operation, and almost certainly dies within twenty days.? Tin: From thft construction and limited range of the oftieial returns, ir is iiiip.issil.lf to show in figures what a result of the surgery of the. that though union did in v. - follow compound tract ur.-s in the middle and lower third of the thigh, still the ultimate per-eentageof loss was greatly less when primarv had leen than when liml tved, or tried to he preserved, or rcmovid at a late period.
AVhen we take into consideration fact so well brought out by the authors of the:iipendiuni de Chirurgie Pratique," and partly given in the note'that we should, on the one side, calculate those who die before the period for consecutive ainputaund, as well as those who do not recover If we take 100 wounded," says the author of the article. " Plaies d'armes a feu," "all of whom have received severe injuries of the necessitating amputation, and operate immediately if, on the other hand, we take another hundred in the same condition, and wait to perform secondary amputation on those who survive the prim r. an<l then compare results, as far as it is possible to judge from observations borrowed from military surgeons, here is what follows in either case.