appearance and
fairly circumscribed swelling. No evacuation of the bowels had taken
place for over two weeks, and as the patient suffered from singultus
and constant pain over the epigastric region, a light cathartic was
given, which, in twenty-four hours, gave relief. The four frozen limbs
were enveloped in a solution of zinc chlorid. The frozen ears and
cheeks healed in due time, and the gangrenous parts of the nose
separated and soon healed, with the loss of the tip and parts of the
alae, leaving the septum somewhat exposed. On January 10th the lines of
demarcation were distinct and deep on all four limbs, though the
patient, seconded by his wife, at first obstinately opposed operative
interference; on January 13th, after a little hesitancy, the man
consented to an amputation of the arms. This was successfully carried
out on both forearms, at the middle third, the patient losing hardly
any blood and complaining of little pain. The great relief afforded by
this operation so changed his aversion to being operated upon that on
the next day he begged to have both legs amputated in the same manner,
which was done, three days afterward, with the same favorable result.
After some minor complications the patient left for his home, perfectly
recovered, June 9, 1866.

Begg of Dundee successfully performed quadruple amputation on a woman,
the victim of idiopathic gangrene. With artificial limbs she was able
to earn a livelihood by selling fancy articles which she made herself.
This woman died in 1885, and the four limbs, mounted on a lay figure,
were placed in the Royal College of Surgeons, in London. Wallace, of
Rock Rapids, Iowa, has successfully removed both forearms, one leg, and
half of the remaining foot, for frost-bite. Allen describes the case of
a boy of eight who was run over by a locomotive, crushing his right
leg, left foot, and left forearm to such an extent as to necessitate
primary triple amputation at the left elbow, left foot, and right leg,
the boy recovering. Ashhurst remarks that Luckie, Alexander, Koehler,
Lowman, and Armstrong have successfully removed both legs and one arm
simultaneously for frost-bite, all the patients making excellent
recoveries in spite of their mutilations; he adds that he himself has
successfully resorted to synchronous amputation of the right hip-joint
and left leg for a railroad injury occurring in a lad of fifteen, and
has twice synchronously amputated three limbs from the same p