CASE 251.—A private soldier of General Pope's Army of Virginia, was admitted on September 2, 1862, to the Cliffburne Hospital at Washington, D. C., with a gunshot fracture of the neck of the left femur, received at the second Bull Run battle, on August 29, 1862. A conoidal musket ball had entered the left hip directly over the trochanter major and embedded itself in the neck of the femur. The trochanter major and the neck of the femur were split and comminuted, but the head was uninjured. The patient had suffered greatly from the journey from the battle-field to the hospital, and was prostrated by diarrhœa and malarial complications. The tissues about the hip joint were but slightly swollen, and the wound discharged healthy pus. It was decided that excision was the most hopeful resource, and on September 4, 1862, Assistant Surgeon John S. Billings, U. S. A., proceeded to operate. Chloroform was administered, and a straight incision was made over the trochanter major, and the head and fragments of the neck were removed. The shaft of the femur was then divided by a chain saw at the level of the trochanter minor. The patient reacted well from the operation. He was placed on a fracture bed, and extension by means of a weight was made on the injured limb. The diarrhœa increased in severity despite all treatment, and the patient succumbed, exhausted, on September 24, 1862, twenty days after the operation.