200 ON ANTISEPTIC DRESSING UNDER 



it presents at the dorsal aspect a transverse prominence, caused by the growth 

 of new bone from the divided end of the radius, which seems to have become 

 expanded into a socket for the reception of the ends of the metacarpal bones 

 which have been rounded off by ossific deposit. Thus, a new joint has been 

 constructed, of a form which, I may remark, I have seen in another case after 

 the same operation. The formation of new bone has not taken place to the 

 same extent from the ulna, and the hand has in an exaggerated degree the 

 droop to the ulnar side which it assumes in the normal condition of the limb 

 in a state of repose. Nevertheless, eversion and inversion of the hand can be 

 carried through as great an angle as usual, proving that the tendons of the 

 flexors and extensors of the wrist, necessarily divided in the operation, have 

 formed secure new attachments. Flexion and extension of the wrist, and 



pronation and supination, are, you see, freely 

 performed, and every joint of every digit has 

 its normal movement, those of the knuckles 

 only being not quite so free as in the other 

 hand. You remark the perfect freedom of 

 the actions of the second joint of the thumb, 

 the extensor secundi internodii pollicis having 

 been left intact by placing the radial incision 

 in the angle between it and the indicator, 

 where the cicatrix is still seen. The hand has a 

 powerful grasp, as any of you may be satisfied 

 by shaking hands with him. [The patient, 

 before thus exhibiting his powers to the members of the Society, made a state- 

 ment to the effect that he was engaged in charge of a steam-engine, and found 

 his left hand equal to the right for all sorts of work, including wheeling a heavy 

 barrow, and various other actions of a laborious and complicated character.] 

 This case, Mr. President, is certainly very gratifying, as an example of what 

 may be done in the way of saving a hand from amputation by means of excision ; 

 but it is still more gratifying to be able to avoid excision by early free incision, 

 practised antiseptically, before sinuses have formed, and followed up by anti- 

 septic dressing. Five cases of this kind in the adult have occurred in my practice 

 in the course of the last year, and useful as is the hand which you have just 

 seen, it is of course not equal to the perfectly natural condition that may be 

 retained by antiseptic management. 



The next case I have to show illustrates what I believe will be found a 

 valuable method of treatment for certain cases of 



Deformity from Contracted Cicatrix. — This young woman fell into the fire 



