240 
REPORTS OF CASES. 
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upon his foot the uncontrollable piece of hone jumps from its nor¬ 
mal to the abnormal position, notwithstanding the continued sup¬ 
port being practiced by the hand to keep it in situ. Bepeated 
attempts to effectually reduce the luxation are frustrated by the 
same resisting influence. The internal fragment of the patella 
is at this examination not perceptibly dislodged, nor does it con¬ 
vey any preternatural mobility by manipulating this region but, 
as the post-mortem examination has shown it did, either at the 
time of accident, or at some subsequent time, slip from the 
trochlea into the space in front of the internal condyle of the 
femur. This fact did not occur to me on my ante-mortem ex¬ 
amination, owing to the extensive swelling, and the fixedness of 
the fragment. Being confident that it is impossible to bring the 
fractured portions of bone into their normal position and to re¬ 
tain them there by any conceivable means, and without this the 
case being necessarily incurable, I ordered him to be destroyed. The 
owner, however, objected, and concluded to keep him in pasture, 
speculating on a spontaneous cure. To satisfy my inqusitive- 
ness as to the progress of the case, 1 repaired to the place again 
on the 16th of June and found him running at large. He was con¬ 
siderably emaciated, but I am informed that he was in a worse 
condition, and is now thriving again. His right gluteal and 
crural region of muscles are very much atrophied. He stands 
resting his toe on the ground, and when urged to go, bears con 
siderable weight on his toe, at the same time keeping his stifle and 
hock joints much as on my first visit. This position, with the 
atrophy of the muscles, makes a shortening of the limb quite ob¬ 
vious. The stifle joint is very prominent, swollen, indurated, 
and painful to the touch. By manipulating the external mass 
of the fractured patella, which still lies at the outer and lower 
surface of the inferior extremity of the femur, probably not 
quite as low as on my preceding examination, I perceive a 
limited motion conveying a gritty, squashy sensation, owing to 
the adhesions and adventitious tissue that have formed around it. 
For the reason that the horse has improved somewhat in his 
gait, and the acute symptom having subsided, his owner is still 
unwilling to have him destroyed at present. I however, endeavored 
