324 THE NEW WORLD OF SCIENCE 



moved and the muscles are exercised, the extension pull remains 

 constant, the patient is no longer helpless and dependent upon 

 nurses or orderlies even to shift his position in bed; he can 

 move about in bed to a limited degree, of course, and is required 

 to move and exercise the muscles and joints of the fractured 

 extremity. This process hastens bony union in that it improves 

 circulation, prevents stiffness of joints and atrophy of muscles 

 from disuse, and thus again shortens the period of conva- 

 lescence, allowing the use of the injured member much earlier 

 than was formerly thought possible. Too, the early use of 

 ambulatory splints for walking during convalescence hastens 

 return to normal use and lessens the vicious " crutch habit." 



Though nothing new has been added in the matter of bone 

 grafts, bone grafting is now done with greater success probably 

 than formerly. Instead of covering in defects of the skull 

 with foreign material, such as metal plates, as heretofore has 

 been the usual practice, it has been found that a thin shaving 

 of bone with its covering membrane or periosteum transplanted 

 bodily from a nearby portion of the uninjured skull, will unite 

 with the bone around the defect, will grow and thus give a 

 homogeneous bony covering for the area of lost bone. 



When amputation has to be performed, greater attention is 

 now directed to the effort of obtaining an end-bearing stump, 

 that is, a stump which will take the weight of the body, when 

 the leg or thigh has been amputated, on the end of the stump 

 against the artificial limb, instead of the pressure of weight- 

 bearing falling upon the sides of the stump. An end-bearing 

 stump is altogether desirable and offers many advantages. 

 Now, under the supervision of the surgeon, hardening and 

 toughening of the end of the stump is begun as soon as healing 

 permits, and by graduated steps of pressure and pounding and 

 the early use of a temporary or provisional artificial leg, the 

 stump is rendered fit for the wearing of the permanent limb 

 much earlier than formerly. Also, more attention is paid to 

 the " shrinking " of the stump, with the same end in view. 

 All of this is done under the supervision of the surgeon and 



