§22 VETERINARY SURGICAL THERAPEUTICS. 
first method is to make the animal walk, holding his head high to pre-~ 
vent its falling, and, if necessary, urge him with the whip. Most ordi-’: 
narily after a few days the patella is unhooked and everything is in 
order. If walking fails, the animal must be made to back. If those do. 
not succeed, apply a rope round the coronet, run it over the withers, have. 
the leg carried in extension, and with the hand push the patella down- 
wards and inwards.. Some prefer to practice this while the animal is 
down and securing the lame leg in the position indicated for castra- 
tion. 
In general, the luxation is easily reduced; but, as we have said, re- 
lapses are frequent. Under the influence of methodical moderate work 
it returns only at intervals, sometimes further and further apart, and then 
disappears altogether. To hasten recovery, frequently repeated water 
douches can be prescribed, or blistering ; friction on the stifle and nutri- 
tious diet, the bandage of Bernard, the apparatus of Weber, to hold the 
patella in place, are little used. 
To overcome the “cramp of the vastus internus,” Violet, after Tre- 
lut, advised the administration of one or two hundred gramms of cherry 
bark distilled water, diluted in honey and water. In rebel cases, to this 
antispasmodic treatment he associated blisters. 
When the pseudo-patellar luxation does not yield to those treatments, 
it is indicated to divide the internal tibio-patellar ligament, as recom- 
mended by Bossi. 
The modus operandi is simple. The animal thrown on the lame 
leg, the internal face of the stifle is exposed by carrying the opposite 
hind leg forwards, as in the operation of castration, or in fixing it on the 
corresponding fore leg, above the knee. The skin is shaved and asep- 
tized. The straight tenotome, held in a very oblique direction, is im- 
planted flatwise, back of the internal tibio-patellar ligament, immediately 
above the superior extremity of the tibia; withdrawing it, the curved 
tenotome is introduced under the ligament, and this is divided subcuta- 
neously. The blood is wiped out and the wound closed with collodion. 
The adipose cushion, situated under the tibio patellar ligaments, pro- 
‘tects the synovial from being injured with the instrument; by dividing 
the ligament very little above the superior extremity of the tibia, where 
this adipose tissue is abundant, one will readily avoid the synovial sac. 
The result is immediate. The wound heals in a few days. 
This operation has given good results to Bassi, Falletti, Loy, Vach- 
etta, Guigas. With this last author, it was successful in a very old 
In the hospital records of the American Veterinary Hospital, Dr. J. Ryder 
reports the case of a stallion which was brought to the hospital for treatment 
of a luxation of the patella of several months standing. With great difficulty 
