Tongue moist and clean, wound healthy, small slouch on miter side not extending. dischaiv Irawn by a eathn, and the sickness greatly prostrated his j;th. Mr. Lakin notes as follows on the 28th: " Rapidly getting worse. Pulse i;jo. eviiy sinking; countenance inneh altt-n-d, but simply l.H.kin-- sunk "ii and pale, and not having the peculiar inia. 1)ie<l at P-teatli. reme. "<!y to liic -drad t.-nt,' the orderlies had oft' plint.and the limli had leen allowed to hail-' down, SO as to destroy any points of' union that then- mi-iit have. 'I'ln vronnd had healed, except its extremities, the granulations on which had shrunk and.issnined a Mack appearance (post the opposed sin the bone.ilar appearance, and then- was no sign of dead bone.
They had leeoine moulded to one another in >hape. there had lie. n any union litre was not evi M adhesions lpik-n. 'I'he ea'. i joint contained only a small Ifl, 'J'lu abscess in t I part of the No purulent deposits eon' phlel.ilis IN"I ascertained," adds Mr. Lakin, "after his death, that, on the 26th and 27th, he had eaten some apples which lie had bought, and that the vomiting and diarrh(va cnine on after that. He had not at all the appearance of a man suffering from pyoemia, but seemed simply to die exhausted by sickness and diarrhoea." " The opening through which the bullet entered remained patent all the time, and a great deal of the discharge escaped through it; though probably the two extremities of the incision would have been sufficiently on the posterior part of the limb to prevent the matter from bagging." Admiring as I do the brave attempts which have been made in civil practice to save limbs by excising the knee, I regret that it should not also be extended to military practice; but except in rare circumstances, I fear that cannot be accomplished, from the careful after-treatment and the long period of convalescence necessary to effect a cure.
Ferguson speaks of more than 100 cases having been now operated on in civil practice, and Butcher has shown that the mortality is greatly less than what succeeds amputation of the thigh; but it is to be remembered that these cases were of an age and a history which rendered the procedure much more hopeful than it almost ever can be in warfare. A diseased joint is a constant source of irritation and depression to the constitution, so that, in the words of Sir Philip Crampton, "by its total excision all those parts which were diseased, and influenced the constitution so unfavourably, are removed from the system, and the injury is resolved into a case of clean incised wound, with a divided, but not fractured or diseased bone at the bottom of it," and thus the powers of the system which went to feed the disease are already \vurxns OF JOIN, the part as to build up the loss, so son.1 work on a proper material.