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gery, but that in spite of this I was sure that if something were not done immediately the woman would have little time to live. I asked if there was not a doctor that could be reached within a few days' journey. We discussed sending the woman to Remate de Males by canoe, but this idea was abandoned, for the journey even undertaken by the most skilful paddlers could not be made in less than eighteen days, and by that time the gangrene would surely have killed the patient. Coronel da Silva was called in. He said that the woman was the wife of the chief of the _caucheros_ and that her life must be saved if possible. I explained my own incapacity in this field once more, but insisted that we would be justified in undertaking an amputation as the only chance of preventing her death. I now found myself in a terrible position. The operation is a very difficult one even in the hands of a skilful surgeon, and here I was called to perform it with hardly an elementary knowledge of the science and not even adequate instruments. At the same time, it seemed moral cowardice to avoid it, since evidently I was the one best qualified, and the woman would die in agony if not soon relieved. I trembled all over when I concluded that there was no escape. We went to the room and got the bistoury and the forceps given me by a medical friend before I left home. Besides these, I took some corrosive sublimate, intended for the preparation of animal skins, and some photographic clips. The secretary, after a search produced an old and rusty hacksaw as the only instrument the estate could furnish. This we cleaned as carefully as possible with cloths and then immersed it in a solution of sublimate. Before going to the patient's hut I asked the owner and the woman's husband if they were reconciled to my attempt and would not hold me responsible in case of her death. They answered that, as the woman was otherwise going to die, we were entirely right in doing whatever we could. I found the patient placidly smoking a pipe, her injured arm over the edge of the hammock. By this time she understood that she was to have her arm amputated by a surgical novice. She seemed not to be greatly concerned over the matter, and went on smoking her pipe while we made the arrangements. We placed her on the floor and told her to lie still. We adjusted some rubber cloth under the dead arm. Her husband and three children stood watching with expressionless faces. Two
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