EXTRACTS FROM FOREIGN JOURNALS. 
473 
above-mentioned structures. The history of fractures implicating 
such bones as the radius and ulna of the fore limb, and femur of 
the posterior extremity, is well known, together with the causes 
so fertile in their production. This case is interesting from the 
successful results which followed amputation after all hope of 
saving the foot was gone, owing to the rapid necrotic changes 
which supervened. Primarily, the treatment adopted was in 
accordance with the recognized principles of modern surgery, 
viz., (1) reduction of the part, or bringing the displaced portions 
into their normal position; (2) maintaining them in such position 
until repair had been effected; (3) preventing or combating the 
local and general accidents. 
Manipulation of the foot on the evening of the 8th of Sep¬ 
tember revealed a compound comminuted fracture of all the 
digits, except the first, of the right foot, as well as the inferior 
portions of the metacarpal bones. There was much laceration of 
muscular structure, with several deep wounds communicating 
with the fractured bones, which comprised a number of pieces. 
Temperature registered 102.5° F., as taken per rectum; respira¬ 
tions hurried; rigors; profuse sweating, notably at the neck and 
flanks, with groaning—all indications of severe pain. The diet 
of the patient was attended to some hours following the preceding 
treatment, and was readily partaken of. Thirst considerable, and 
continued for several days, and was a notable feature of the case. 
As prostration was manifested on the 9th inst, stimulating tonics, 
as spts. atnmon. con., tinct. gent, con., equal parts, were adminis¬ 
tered morning and evening. 
On the morning of the 11th of September, notwithstanding 
the precaution adopted by disinfecting the parts, a discharge of a 
sero-sanguineous nature continued with much foetor, and, as was 
to be expected, oedema of the foot, which was now cold and de¬ 
nuded of hair. Examination revealed structural alterations of a 
necrotic nature, which had rapidly seized upon the digits particu¬ 
larly, and would shortly have affected the metacarpals. The ter¬ 
minal portions of the following structures more particularly were 
easily distinguishable, viz., ext. oblique of metacarpus, long ab¬ 
ductor and short extensor of the thumb, and the common extensor 
