The excisions performed on the head of the humerus, and on the bones composing the elbow-joint, have been very successful. There is, however, a circumstance to which I am desirous of drawing attention, viz., that the head of the humerus should never be removed in amputations, when it is uninjured, however close the destruction below may have approached it. The round head of bone left in the socket preserves the squareness of the shoulder, and renders the loss of the arm less unseemly. It tends to prevent the inclination the body generally has to the opposite side, and its being left adds nothing to the difficulties of the operation. The excisions of the ankle-joint have been numerous and more successful than might have been expected under the depressing causes alluded to.

For the preparations of the head of the humerus and of the astragalus, referred to at pages 110 and 128, I have since learned I am indebted to Deputy Inspector-General Macgregor; and I am particularly so to Assistant-Surgeon Gregg, of the 17th Regiment, for the great care he has bestowed on several of the specimens of injury sent to me.

Wounds penetrating the cavities of the chest and abdomen have been no less fatal than those of the lower extremities. The same want of power has been exhibited in them; the same inability to bear the means of cure which, under happier circumstances, have proved successful.

I hope to receive reports on wounds of arteries, on secondary hemorrhage, and on injuries of the head, so as to enable me to remove any doubts which may exist on these points; and I beg to assure those officers who will favor me with their opinions and facts, that they shall be duly reported in another “Addenda.”

I cannot conclude these remarks without expressing my sense of the great practical ability displayed by very many of the medical officers in the Crimea, of their devotion, of their self-denial—qualities which ought to obtain for them the special approbation of the nation.

October 18, 1855.

INDEX.

INDEX OF CASES.