In 1916, in the service of the British expeditionary forces, France, there was much discussion among the medical officers regarding the best method of active care of these serious injuries. On the whole, there was a tendency to collate the different treatments and to watch for final results. In the late part of the year, a course of action crystallized out of this chaos. During 1916 at the general hospitals, victims of battle casualties were frequently received fresh from the trenches, when only slight operative interference had taken place. This was especially true of gunshot wounds of the knee. A perusal of the tabulation made at that time to cover these patients now seems unsatisfactory, although any desired line of procedure in treatment was then possible for the relatively untouched wounds. Sepsis predominated. Mortality was high, and nearly one half of these cases went on to high amputation. Now, a