THE BRITISH MEDICAL ASSOCIATION 193 



not occur, the procedure would be free from danger. Well, if I believed that 

 I could do it with safety, and that it would probably have the effect of restoring 

 the man to usefulness, it became my duty to do it ; and I resolved to make 

 the attempt. Accordingly, on the 2nd of December, 1868, the patient having 

 been put under chloroform, I first moved the extended limb in all directions 

 with the utmost freedom, so as to break down adhesions, which gave wa\- with 

 a report that could be heard all over the operating theatre. Then I applied 

 the pulleys, and practised extension to the utmost degree that appeared 

 justifiable, in order to draw down the lower fragments ; and, the patient being 

 placed on the sound side, with the pulleys still in operation, I cut down above 

 the trochanter with a free longitudinal incision, the knife being smeared with 

 a solution of carbolic acid, in four parts of olive oil, which was also continually 

 poured into the wound — a very inconvenient mode when compared with the 

 spray. At length, having cut down to a sufficient depth, I found, to my joy, 

 that the tip of my finger, dipped, of course, in the oil, could be passed between 

 the fragments, the ends of which, though irregular, felt smooth, as if covered with 

 cartilage. I now took a gouge dipped in the oil, and roughened the edge of 

 each fragment, producing abundance of bone-chips. I did not think it worth 

 while to take out the chips ; because, supposing putrefaction avoided, I expected 

 the chips to be absorbed. A large piece of lac-plaster was then applied as an 

 external dressing ; and, while the pulleys were still acting, a long splint was 

 put on very firmly, with iron bars substituted for the wood opposite to the seat 

 of operation, to permit access for dressing. A few hours later, my house surgeon 

 came to tell me that there was serious bleeding. I went at once, and found 

 that such was indeed the case, the blood having gone through the patient's 

 bed, and made a pool on the floor. Without disturbing the sphnt, I carefully 

 removed the dressings, and proceeded to plug the wound with long strips of 

 lint dipped in the solution of carbolic acid in oil, feeling sure that, as there had 

 been no material bleeding at the operation, plugging would be sufficient : and, 

 as I pushed these plugs home, with ni}- fingers dipped in the oil, and felt the 

 mass of clotted blood, with the multitude of osseous fragments among it. I almost 

 wondered at my own hardihood in making voluntarily a compound comminuted 

 fracture of the neck of the femur. For it is one thing to do as Mr. Cresswell, 

 whom I see before me, did with such striking success three years ago. to 

 treat antiseptically an existing compound comminuted fracture of the neck 

 of the femur — and that remarkable case, resulting from gunshot-wound, 

 ought, I think, to have attracted more attention than it did' — but it is 

 quite another thing to produce such an injury voluntarily. However, the 



' Sec Lancet, August J9, iS6t3. 



