In fractures of the leg, where neither the knee nor ankle joints are implicated, the results of conservative attempts have been more favorable. In the Crimea, the recoveries without amputation being resorted to were: in fractures of both bones, nearly 19; tibia only, 36·3; fibula only, 40·9 per cent. When the fracture is comminuted, and implicates the knee or ankle joint, opening the capsule, amputation is necessary. The knee–joint was once excised in the Crimea, but the patient died; as was the case in the only other instance where this operation is known to have been performed for gunshot injury in the Sleswick–Holstein campaign. In the treatment of fractures of the leg, where it has been determined to seek union, the same remarks apply as those made above in respect to fractures in the upper extremity. In wounds of the foot it is especially necessary to remove as early as possible all the comminuted fragments of the bones injured, or tedious abscesses and much pain and constitutional irritation are likely to ensue. AMPUTATION. It is not necessary to refer at much length to the question which was formerly disputed upon—the advantages of _primary_ as compared with _secondary_ amputation in gunshot wounds—for military surgeons, whether acting at sea or on land, have practically determined the subject. For a long time the directions of John Hunter, that amputation should not be performed until the first inflammation was over, based on the argument that the “amputation is a violence superadded to the injury, and therefore heightens the danger,” and that this danger is aggravated in the instance of a man laboring under mental agitation, as on the field of battle, had great weight among English surgeons; but experience has led to a different practice. The greater success of primary amputation appears to be attributable to the facts, that a contused and mangled limb is a constant source of accumulating irritation; that the exciting circumstances connected with battle lead a man to bear with courage at an early stage what subsequent suffering and anxiety may render him less willing to submit to; that a soldier, when first wounded, is most probably in stronger health than he will be after hospital restraint and confinement; that though the amputation is a violence, it is one the patient is likely to submit to with resignation, knowing that it is performed to remove parts which, if unremoved, will destroy life; and lastly, because the operation takes away a source of dread which must weigh down the sufferer so long as it is impending. The present practice has resulted from testing both modes of amputation. Mr. Guthrie showed, from the experience of the Peninsular war, that the loss in secondary amputations had constantly exceeded that from primary amputations in both the upper and lower extremities. More recent observations in both English and French campaigns have confirmed this result. Dr. Scrive records that