Of the 2 cases in which amputation was done in the
Thigh, one was for mortifieation after compoimd comminuted
fracture of the leg, and the other for gangrene, after simple
fracture of the thigh-bone^ with nipture of the popliteal
arteiy and vein*

The patient in whom the arm was removed at the
shoulder-joint J was a married woman, 45 jears of age,
under my eare. She had scalded^ or bnnitj the arm and
shoulder^ 3 days before admission^ during some ^^fit/* or in
an attack of mania. The operation was performed on the
7th day after admission. She refused all food after the
operation^ and became m unmanageable that the wound
could not be pTotected from her violence. She died in 26
hours, — apparently linking from maniacal exhaustion.^
(234.)

This is the only case since the Radcliffe Infirmary was
opened in which the arm has been removed at the shoulder-
joint. In 4 late cases the operation might have been done,
if it had been thought desirable so far to disfigiure the
patient. (137, 164, 19.6, 198.) In one of them there was a
fracture through the neck of the bone, beside the injuries
for which amputation was performed. (196.)



i



One other case might be added to these Secondary
Operations, in which the patient underwent the danger,
though not the actual surgical operation.
A boy, aged 13, was admitted 14th February, 1856,
under the care of Mr. Symonds, with his left foot and ankle
crushed in a thrashing machine 3 days before admission.
' The case is fully reported in the Asylum Journal, July, 1855.
AMPUTATION OF THE LIMBS. 235

The foot, which was gangrenous^ was afterwards separated.
The wound healed quickly, and the boy was discharged on
the 9th of April, with a good stump.
