operate, rapidly glances over the table, and sees that his instruments are all there, and in readiness. He requests a colleague to take charge of the tourniquet, and with a word deputes one assistant to "take the flaps," another to hold the limb, a third to hand the instruments, and the last to take charge of the sponges. This done, and while the patient is inhaling chloroform in an adjoining apartment, under the care of a gentleman who makes that his special duty, the operator gives to the now hushed and listening auditory, a brief history of the circumstances which led to an incurable disease of the left knee-joint, and the reasons why he decides on the operation about to be performed. He has scarcely closed, when the unconscious patient is brought in by a couple of sturdy porters, and laid upon the operating table, a small, but strong and steady erection, four feet long by two feet wide, which stands in the centre of the area. The left being the doomed leg, the right is fastened by a bandage to one of the supports of the table, so as to be out of harm's way; while the dresser, who has special charge of the case, is seated on a low stool at the foot of the table, and supports the left. The surgeon who assists, encircles the upper part of the thigh with the tourniquet, placing its pad over the femoral artery, the chief vessel which supplies the limb with blood, and prepares to screw up the instrument, thus to make sure that no considerable amount of the vital fluid can be lost. The operator, standing on the left side of the corresponding leg, and holding in his right hand a narrow, straight knife, of which the blade is at least ten inches long, and looks marvellously bright and sharp, directs his eye to him who gives the chloroform, and awaits the signal that the patient has become perfectly insensible. All is silence profound: every assistant stands in his place, which is carefully arranged so as not to intercept the view of those around.
The words "quite ready" are no sooner whispered, than the operator, grasping firmly with his left hand the flesh which forms the front part of the patient's thigh, thrusts quietly and deliberately the sharp blade horizontally through the limb, from its outer to its inner side, so that the thigh is transfixed a little above its central axis, and in front of the bone. He next cuts directly downwards, in the plane of the limb, for about four inches, and then obliquely outwards, so as to form a flap, which is seized and turned upwards out of the way by the appointed assistant. A similar transfixion is again made, commencing at the same spot, but the knife is this time carried behind the bone; a similar incision follows, and another flap is formed and held away as before. Lastly, with a rapid circular sweep round the bone he divides all left uncut; and handing the knife to an assistant, who takes it, and gives a saw in return, the operator divides the bone with a few workmanlike strokes, and the limb is severed from the body. A rustling sound of general movement and deeper breathing is heard among the lookers-on, who have followed with straining and critical eyes every act which has contributed to the accomplishment of the task; and some one of the younger students is heard to whisper to his neighbour, "Five and thirty seconds: not bad, by Jove!"
