ALTITUDE ON THE RESULTS OF SURGICAL OPERATIONS. 
661 
In 1894 Mr. A. had a well-bred filly, about nine months old, 
which suffered a fracture of the metacarpal bone (great) about 
the distal third ; the skin was broken and the ends of the bone 
protruded and were exposed to the air for hours. I was called, 
when I found the bone severed and exposed. I advised destruc¬ 
tion of the filly. The owner wished me to make an effort, as 
he wished her for a brood mare, even if she could not be driven. 
I used the saw to remove the blackened ends of bone and 
thus make a fresh surface, stitched the wound, put the limb in 
plaster bandages, leaving the stitched wound uncovered ; after 
this a second set of splints with bandages without plaster were 
used ; those were removed at various intervals to cleanse the 
wound. At the end of the eighth week I removed the plaster 
cast to find a good union ; the leg was short but almost straight, 
and to-day she drives fairly well. This farm is located about 
1000 feet above the lake. 
* 
Buoyed up with this success I tried the next such case for 
Mr. H. on the low lands. I was on the ground in less than 
forty-five minutes after the accident, reduced the fracture and 
treated the case similarly, but I was often called to watch my 
patient being dressed, where I did not visit my first patient but 
once. I will just tell the story shortly. I was obliged to de¬ 
stroy the animal in two weeks; putrefaction got ahead of me. 
Since then I have attempted three cases in the mountainous 
country with one failure, for I had a comminuted and a com¬ 
pound fracture where the particles were not displaced until 
time ate away the periosteum, and then destruction was my final 
treatment. In the low lands if the skin is the least injured I 
have serious troubles with fractured limbs. 
Some time ago while in conversation with Dr. Ransom, 
hospital physician at Dannemora State Prison, I related to him 
some of those facts. He told me that in the hospital he thought 
as little of amputating a leg as if it were but a finger or simple 
operation. He can operate on a patient to-day, and go for a 
fishing tour the next day. Dannemora hospital is just 1500 
feet above the lake. 
