through even a very ^ 
elasticity due to the elasticity of the ligaments, but in a way to satisfy the 
surgeon that the cartilages are sliding one upon the other, however little, 
my rule is to leave the rest to nature, with entire confidence in the result; 
allowing the patient to take off his splint daily, and as he pleases; to flex 
and extend it as the pain and tenderness may allow him, encouraging 
him in his attempts to reach his forehead with his hand. I have also often 
advised a patient to bore holes in a soft board with a small gimlet, to 
increase the power of rotation. But if the cartilages do not slide through 
even a small arc, and motion is restricted, elastic and springy, owing to 
bony deformity, so much the worse for the patient, and so much the 
longer and less perfect the recovery. I do not believe you can accelerate 
it by passive motion, as the term is usually understood; you give the 
patient a good deal of suffering and the joint a good deal of inflamma¬ 
tion. If these views of passive motion are correct, the teaching of the 
books should be received with considerable qualification 
. . . Exactly how far these remarks on passive motion apply to the 
knee and other joints and injuries, I will not attempt here to define, but 
can only say that I have seen more harm than good arise from forcible 
flexion of the knee after rheumatism and after fracture of the shaft of the 
femur. In simple fractures of the elbow, except of the olecranon, these 
remarks may be summed up as follows always etherize the patient, go 
through the motions of reducing a backward dislocation of the forearm, 
and apply an internal angular splint. When there is bony deformity or 
projecting callus, passive motion does harm; and when the bones are in 
place and under supervision, it is unnecessary. 
Botanical 
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