First, A mortification, which spreads till it reaches the bone. Secondly, Any limb so greatly hurt, whether by fracture or dilaceration, that there is room to dread the most fatal consequences, a mortification and death. Thirdly, A violent contusion of the soft parts, which has at the same time shattered the bones. Fourthly, Wounds of the larger vessels, which convey the blood into the limb, either, as the only means of stopping the hemorrhage, or through the apprehension the limb should perish for want of nourishment. Fifthly, An incurable caries of the bone. Sixthly, If any part is either attacked with a cancer, or is in danger of being so, it is customary to take it off. I shall treat of these different accidents more or less particularly, in proportion to the number of observations I have made on each of them, as no method of cure, however doubtful and alarming, should be rejected, till a better can be pointed out. Thus, this treatise contains only, in effect, an account of the methods I successfully employed in the military hospitals, for the relief of the above disorders; together with a few observations, and still fewer hypothetical reasonings, which induced me to condemn the use of amputation. SECT. VII. I shall begin with an account of the means I make use of, internal as well as external, when a limb is mortified, the effects of which have convinced me, that in such cases amputation is not necessary; and here I shall first gratify the curiosity of those readers who, doubtless, are desirous to know what I have learned from the extensive opportunities I must necessarily have had, with respect to the use of the Peruvian bark. Experience has taught me, that this admirable medicine is possessed of a singular and specific virtue in mortifications. I know that several physicians and surgeons only recommend it in those which proceed from weakness. I have heard it reported by others, that they found it of little service after the famous battle of Dettingen[7]. But perhaps the other circumstances, with regard to the treatment of the patient, did not contribute to promote those good effects which I always observed attended it when judiciously administered. And I make no doubt, but every practitioner who, in prescribing it in cases of mortification, observes the rules laid down by Dr. Pringle, Dickins, Wade, Cheselden, Douglas, Rushworth, Amyand, Shipton and some others, will find it very efficacious. I do not mean, nevertheless, that it should be considered as the only internal medicine; there are, doubtless, other bitters which are sometimes extremely proper on these occasions. I must add, that the bark appears to me to possess that quality which Celsus requires in medicines, whether in a solid or liquid form, adapted to the cure of a mortification, to bind the belly moderately, and brace the whole system. After having treated of the external applications, I shall point out the method in which I administered the bark. FOOTNOTES: