the skin and bringing disease and death in its train. That night John Taylor, whose stump had healed by the first intention, leaving only a trifling discharge from where the ligatures were withdrawn, was seized with bilious remittent fever; the symptoms were too unequivocal to be neglected, and early the next morning I represented to Captain Chetham, the urgent necessity for our departure from Gibraltar, as I feared not only that the fever would extend itself amongst the wounded and those in health, but that the wounds were beginning to assume a more unfavourable appearance. The captain immediately waited on the commander in chief, who permitted us to sail, notwithstanding our supplies had not arrived from Tangier. We could not get away until the afternoon, and that day three others were affected with symptoms similar to Taylor's. The propriety of sailing soon evinced itself by no others. being ill, and the three men who were seized on the 14th having no return of the paroxysm. One of the seamen who slept on shore on the night of the 13th was seized with febrile symptoms; he was bled freely, and evacuants were used with the desired success. Taylor was bled, and every means were tried to check the progress of the disease, but in vain. He expired on the 20th. The liver was surcharged with blood, and a large abscess formed in its centre. The heart was soft and flaccid, and the pericardium contained considerably more fluid than usual. The intestines bore evident marks of bilious suffusion, and the skin and eyes were per

fectly yellow. Previous to his decease the disease had assumed more of the remittent type. I myself had a slight attack on the 15th, 16th and 17th, but it was soon checked by evacuating remedies. On the 21st Mr. Ashington, midshipman, fell a victim to his desperate wounds, after bearing the most exquisite suffering with a fortitude, resignation, and patience, surpassing all belief. The left acetabulum and the head of the thigh-bone were shattered to pieces. The pubes was splintered to the symphysis, and the os ilium to its spine. The fatal grape-shot entered between the glutei muscles, and after hurling destruction along, such was its velocity that it escaped at the right groin. In viewing its desolating progress, after the death of this fine young man, we could not avoid admiring the wonderful dispensations of the Almighty, who alone could support him under such an accumulation of injury for the space of twenty-five days. The discharge had latterly become extremely copious and most offensive.

Thirty-six men are now on the list with very severe wounds, and I fear one or two of the fractured limbs will require amputation; indeed, I conceive it bad practice to attempt saving limbs in cases of fracture of the large cylindrical bones from grape or musquet shot, as it would not recom pense for the suffering which the patient must undergo. The difficulty of keeping the separated ends in apposition on board of ship; the large

formations of matter; the tedious and troublesome exfoliations, and the imminent risk of being forced to have recourse to amputation at last; together with the probability of the poor fellows sinking under such an aggravation of disease, are considerations which should, I think, induce the naval surgeon to amputate immediately; however, we cannot at all times emancipate ourselves from the slavery of custom, or the entreaties of the person most concerned. Seventy-six have already been restored to the service, and six are rendered incapable of further service. The wounds all look healthy and clean; we have been daily occupied in extracting musquet balls, pieces of langrage, &c., from the various parts of the body; and it is most singular to observe the variety of courses they have taken, and the narrow escape of parts of the most vital importance. By my having completed my supply of necessaries at Portsmouth, and having had a number of bandages of my own, we were enabled to replace them clean every morning, without having recourse to the hard canvas of filthy bunting. At Gibraltar we were most amply supplied by the army medical department. Dr. Frazer and his staff are entitled to the gratitude of the navy for the admirable arrangements made for the comfort and accommodation of the wounded, and the handsome way in which they tendered their services. But the desire of the men to return to England, and the advantage of restoring them to a more eligible climate, were so obvious, that we could not avail

ourselves of their excellent disposition. Two circumstances contributed greatly to the favourable result of the operations, the nourishment and comforts afforded to the wounded men by Admiral Milne, Captain Chetham, and the other officers of the ship, who gave up their own stock, and the zeal, tenderness, and perseverance of my two assistants, Mr. Sprowle and Mr. Llewellyn.

I ought also to state, that the alteration of temperature on our passage home, from 70° and 74° to 60° and 65°, had considerable effect in promoting the healing of the stumps.

In concluding, it may be useful to observe, that I have often seen the indiscriminate use of the tourniquet extremely prejudicial in gun-shot wounds. This instrument is seldom required in naval actions, excepting in operating, and I have long been in the habit of cautioning my assistants against its use, unless where it is obviously required. The fear of hæmorrhage is the greatest dread of the seaman; when once the bleeding is stopt every thing must be secure, and whenever they are allowed to have tourniquets in the boats, or in the tops, they apply them in all manner of wounds. The patient fancying himself perfectly safe under the protection of this gigantic fiend, creeps into a corner where he is not discovered, till the ligature has caused the most direful effects, and the otherwise simple wound is rendered highly dangerous,

Sometimes we are under the necessity of postponing the amputation in consequence of swelling and inflammation produced by this instrument where it was not required, and instances have been known in cases where it was necessary, that it has caused so much pain and uneasiness, that the agonized patient has unscrewed the instrument and bled to death. In the late battle, it is said one of the finest young officers I ever saw fell a victim to a reliance on the tourniquet, which he unloosed in the circumstances described above*.

*The question respecting the expediency of early operation in wounds, has been fully and ably discussed in a work published a few months ago, entitled, Some further Observations on the subject of the proper period for amputating in gun-shot wounds, accompanied by official reports of the surgeons employed in his Majesty's ships and vessels in the late battle before Algiers, by A. Copland Hutchison, late surgeon to the Royal Naval Hospital at Deal; surgeon extraordinary to his Royal Highness the duke of Clarence, &c.