I. Tin: relative advantage of primary and secondary amjuitation, has always held the first place among the us problems which the army surgeon lias had to solve. With all that has been written on the subject 1 v military and eivil surgeons, there still seems considerable reluctance to accept the question as settled. The evidence brought to bear on the subject has chiefly arisen frum the evident distinction being overlooked between operations undertaken for i. nt and for disease. Civil affor lar to that obtained from the field of battle, and thus it happens that civil surgeons have come to stand in some measure in apparent antagonbrethrcn on the point of practice under consideration. Hunter was so much of the civilian as to adhere to consecutive operation, although, with very few exceptions, - who have practised in armies have strongly advocated early interterenee since the days of and The II unt.
T sorely not the opinion of military surgeons, with H the exception; - i.,-li,--.. it i allowed by tboe whom we are to esteem the beet those w 1> - of making comparative observations on HMD ui,< difference which so manifestly exists between the moral condition of the patients who are operated on for accident in civil life, and the soldier in the field, together witli the circumstances in which each is treated after operation, introduce so many different items into the calculation of the question of amputation, that it is almost impossible 'to make use of the experience of either sphere to illustrate or influence that of the other. Besides this, the severity of those injuries which present themselves in military practice, and which authorize the removal of the limb, is so great, that it is but reasonable to suppose that an operation which removes so vast a source of irritation and pain at the earliest moment possible, must promise the best results in saving the life.
In short, military experience on this point must regulate military practice, and the results of civil experience must continue to regulate civil practice. To military surgeons, the question of primary or secondary amputation is a settled one. The experience of every war has more and more confirmed the advantages of early operation, and that in the Crimea has not disturbed the rule; in fact, later observation would lead wounded in the same battle, some where amputation had been performed immediately, and others where it had been left till all circumstances favoured the operation; it has been found, I say, that few did well who had their limbs cut off on the field of battle, while a much greater proportion have done well in similar cases, who were allowed to go on till the first inflammation was over, and underwent amputation afterwards." Contrast such sentiments witli the immense mass of facts scattered throughout the works of Larrey, Outline, Hennen, and, in fact, of every military surgeon who has published his experience in this or foreign countries for many years, and then let us be led, in estimating this long-contested question, by what Hunter says is "the best guide," viz., experience.