462 AN ADDRESS ON THE TREATMENT OF 



were well padded, to support the sides of the foot. With regard to this 

 patient, again, I have to show a temperature-chart free from any febrile 

 indication. In eight weeks after the operation the patient was allowed to 

 get up, and she walked about on crutches. She was discharged three weeks 

 later, able to bend the knee slightly, lowering and raising the foot three or four 

 inches. 



On the 14th of February the patient was readmitted, to have the wire 

 extracted ; and, five days later, she was finally discharged. It will be 

 remembered that this was a case of ununited fracture ; and that, when the 

 patient left the hospital, she could only move the foot through a distance of f 



about four inches. On the 22nd of February of this year we had an oppor- 

 tunity of seeing her, and then the following note was taken : ' There is perfect 

 union of the fragments. She can walk from Drury Lane to Billingsgate and 

 back, and walks without a limp. She can bend the knee to a right angle, and 

 says the mobility increases every day. From the position at a right angle, 

 she can raise the leg in a perfectly natural manner to the extended position. 

 She is a stout, heavy woman. She cannot kneel.' 



[The patient was now introduced and exhibited. There seems to be a 

 perfect patella ; there is nothing abnormal to be felt about it. She says she 

 can do everything except kneeling.] 



The next case was one of recent fracture. William G , sixty-two years 



of age admitted on the 21st of June, 1881, a healthy man, but a pretty hard 

 drinker. On the morning of his admission he slipped, put out his right leg to 

 save himself, fell, and could not rise. His leg doubled under him. On admission 

 the patella was found fractured transversely, with one inch of interval between 

 the fragments, which could be brought together with difficulty. The knee 

 was considerably swollen. On the 24th, that is three days after the accident, 

 I operated upon him. The operation was conducted precisely as in the cases 

 that have been before described, except that, unlike the two last, there was 

 no necessity for refreshing the fragments. It was merely necessary to take 

 away the clots of blood and any effused fluid from the interior of the joint. 

 A few hours after the operation this patient became delirious, and we were 

 apprehensive of delirium tremens. However, he was quieted with a dose of 

 opium, and gave no further trouble. The temperature-chart here, as in the 

 last case, exhibits entire absence of febrile indication. In this patient, for 

 the first time, the ends of the wire were cut short, and the twist hammered 

 down. The wounds healed without suppuration. Exactly six weeks after 

 the operation he was allowed to get up, and I had the satisfaction of exhibiting 

 him before some of the members of the International Medical Congress, and 



