CASE 653.—Private H. A. Steward, Co. B, 8th Pennsylvania Reserves, aged 23 years, received a fracture of the right leg by a fragment of a shell, at Gaines's Hill, June 27, 1862. He was conveyed to Washington, where he remained under treatment at the Cliffburn​ Hospital until November 20, 1862, when he was discharged and pensioned, Surgeon H. Bryant, U. S. V., certifying to "exsection​ of a large portion of the tibia in consequence of the wound." Examiner George McCook, of Pittsburg, December 17, 1863, testified to the injury, and that "exfoliation is going on in a slight degree. He can walk inconveniently," etc. The pensioner subsequently entered the Good Samaritan Hospital, Cincinnati, where the injured limb was amputated on April 1, 1867, by Dr. Thomas H. Kearney, who certified as follows: "I amputated the leg through the knee joint, the section of the bone being performed through the condyles of the femur. The amputation was rendered necessary in consequence of inflammation of the tibia, leading to abscesses and general infiltration of the tissues. Removal of the condyles was necessitated in consequence of the want of sufficient healthy integument to cover them. The wound he had received involving the tibia, doubtless left it impaired in vitality and prone to attacks of inflammation, such as rendered its removal ultimately necessary." The Quincy Examining Board, in 1872, reported that "the flaps have sloughed from gangrene, leaving the bone only covered with tender cicatricial tissue, which often gives away and becomes an open ulcer," etc. The pensioner was paid March 4, 1880