GiinsJwt Fractures of the Femur. 167 



The back of the inner condyle is wanting, and a circular 

 depression above it indicates where the bullet lay. Portions of 

 the bone which formed the bed of the bullet have necrosed, and 

 have been in process of separation. The joint had evidently 

 been acutely inflamed, and the articular surfaces have been 

 eroded. There is a small crust of new periosteal bone above 

 and behind the condyles. F- P- C. 240. 



Presented hy Professor John Thomson. 



3. 348. Bullet lodg-ed in the Condyles of the Femur.— 



Lower end of a femur — with the patella and adjacent parts of 

 tibia and fibula dissected, and a section removed from the outer 

 condyle to illustrate the above — in spirit. 



A Russian General, Baron Driesen, was struck by a musket-ball on 

 the inner condyle of the left femur at the battle of Borodino on the 6th of 

 September 1812. The ball lodged near the outer condyle. Inflammation 

 and suppuration followed, causing great pain. Various attempts were 

 made to remove the ball by dilating the wound with sponge tents but 

 without success. During 1815 and until March 1816 the wound remained 

 closed. At this time the parts became greatly swollen and very painful, 

 the old wound reopened, and an abscess on the outer side was evacuated. 

 Some improvement followed, and a German surgeon poured large quan- 

 tities of mercury into the sinus in the hope of dissolving the bullet. 

 This was followed by intense pain and numerous abscesses round the knee- 

 joint. As these symptoms continued, the limb was amputated above the 

 knee by Sir Charles Bell on the 7th of January 1817. For a time 

 considerable pain and swelling remained in the stump, but these gradually 

 subsided, and the Baron left London for St Petersburg in May of the same 



year. 



Sir Charles Bell found mercury lodged in different abscesses round 

 the joint and inflammatory thickening round the popliteal nerves. The 

 patella, femur, and tibia were anchylosed by bone. 



An encrustation round the bullet has obscured its metallic 

 character, but indicates its position. (See Bell's "Surgical 

 Observations," p. 431.) B. C. xvii. 38. 



3. 349. Bullet lodged in the Condyles of the Femur. 



Section removed from the foregoing specimen— macerated. 



