Necessity for immediate amputation when an extremity is so wounded as to preclude all hope of saving it; degree of danger attending amputations of the upper and lower extremities; the question us to immediate amputation--of the arm, or leg below the knee; in the upper half of the thigh. Constitutional alarm of shock from the injury. Illustrative cases by Dr. Beith, Dr. Dane, etc. Advantages of primary over secondary amputations; consequences of secondary amputations. Purulent deposits; cases by Dr. Irwin, Mr. Rose, and Mr. Boutflower; case of purulent deposit in the thyroid gland; Daniel Lynch’s case. Inflammation of the veins; cases; two varieties of phlebitis--the adhesive and irritative, or unhealthy; symptoms and treatment of the unhealthy inflammation. The case of Private A. Clarke; of Jane Strangemore; cases of endemic fever after secondary amputation ending in sub acute inflammation of the lungs and effusion into the chest. Employment of the sulphuric acid lotion in sloughing stumps. Writers on purulent deposits: the author’s claims; opinions of Mr. Henry Lee and Dr. Hughes Bennett. Hemorrhage in sloughing stumps, and its treatment; ligature of the principal artery of the limb in such cases, and its failure; hemorrhage after amputation at the shoulder-joint; sloughing of the stump caused by the bad air of the hospital; hemorrhages from irritable stumps not unfrequent in crowded hospitals; symptoms and treatment. pp. 51-73 LECTURE IV. Aphorisms for amputations; necessity for the operation; compression of the femoral artery as it passes over the edge of the pubes; no necessity for the tourniquet in great amputations; the hemorrhage greater when a tourniquet is applied; use of the instrument after amputation; old mode of performing circular amputations; nicking the periosteum injurious; ligature of wounded vessels; bringing together the integuments; dressing the stump; subsequent treatment. AMPUTATION AT THE HIP-JOINT; injuries justifying the operation; case of Captain Flack; wound of the principal artery, with fracture of the femur, necessitates the operation; in malignant diseases of the femur, the operation affords the only chance of success; amputation at the hip-joint not to be done when the bone can be sawn through immediately below the trochanter major, and there be sufficient flaps; mode of operating; prior ligature of the femoral artery, by Baron Larrey; not practiced in the British army; directions for operating; Professor Langenbeck’s mode; Mr. Brownrigg’s; illustrative engravings; amputation by the circular incision; secondary amputation; number of vessels to be tied in primary and secondary operations; Mr. Luke’s amputation of the thigh by the flap operation; protrusion of bone after the operation; exfoliation from badly sawing or splitting the bone, or unduly separating the periosteum. Bulbous enlargement of the divided nerve. pp. 73-89 LECTURE V.