that he had lameness and disability, with but little pain, until January 3, 1897, when he slipped and fell on the floor with the knee bent under him. He was unable to rise or walk, and the neck of the right femur was found to be broken. He was treated by a plaster of Paris application, and in July, 1897, when first seen by Dr. Taylor, he limping badly, the trochanter was one inch above the line, there was extreme eversion and very limited motion. Crutches were advised. In December, 1897, the patient had been free from pain for many months and there was increased motion. In April, 1898, under an anesthetic, more mobility and lessened eversion were gained by manipulation, which was repeated in September, 1898, with further improvement.

Status præsens: Thirty degrees of free lateral motion, considerable free rotation, and 50 degrees of flexion. Trochanter a full inch above the line. Walking was very free, but with a slight limp. An apparatus, soon to be laid aside, was worn to prevent outward rotation.

Dr. Taylor also presented a boy of 18 years who, in December, 1897, fell on his left knee. There was immediate stinging pain in the left hip, but he could walk with some assistance. He soon walked with a cane, and three weeks after the fall there was a marked limp, with very little motion in the hip. The limb was one inch short and rotated outward. The trochanter was one inch above the line, and there were tenderness, induration and muscular spasm about the hip. Treatment was by traction splint, long crutches and a high sole on the foot of the well side. In May, 1898, the patient had been free from pain for two or three months, and there was more motion. In September a cane was substituted for the crutches.

Status præsens: Walking with a considerable limp. No pain. Can raise the leg while lying. Shortening of 11⁄2 inches. Limited motion at the hip and adduction. These cases were of especial interest on account of the youth of the patients and the slight violence of the accidents.

Dr. Whitman said that the first patient doubtless had coxavara, which weakened the neck of the femur, causing it to break under a moderate degree of violence. In three cases of

coxa vara in young subjects he had operated by removing a wedge from the base of the trochanter in order to restore the neck to its normal position and strength. The second patient He recalled the also probably belonged to the same class.

case of a young colored girl who, after a period of slight limping and outward rotation, with slight stiffness in the hip and pain in the thigh, suffered a fall on her way to school. She was carried home with typical fracture of the neck of the traction splint, with femur. She was treated by the use of

a favorable result.

Dr. Taylor said that he was confirmed in his opinion that bending of the neck of the femur had preceded the accident and had made easy the fracture of the bone in the case of the first patient presented. In the second case, however, there had been no previous signs or symptoms of deformity of the femoral neck, and such a condition must be considered hypothetical.

CONGENITAL DISLOCATION OF THE HIP.

Dr. Elliott exhibited a further dissection of the specimen shown at the last meeting of the section.

The disloThe patient had been a girl, 7 years of age. cation of the right hip had been upward and forward. The neck had been found to be short and the muscles shortened and somewhat atrophied. During life there had been more than one inch of shortening, and the child had walked with The head had made a difficulty, like one with weak muscles. deep and exceedingly well defined acetabulum lined with cartilage, below and near the anterior superior spine. The original acetabulum was almost equally well defined, measuring 1% inches in its vertical and 1 inch in its transverse diameter, with a depth of 4 inch. So well defined a first acetabulum Lorenz cited one at 18 years, and the at this age was rare. older anatomists found them at very late periods of life. As a rule, however, the acetabulum not in use failed to keep pace with the development of the other parts, and at an age much younger than that of the specimen it was usual to find it rudimentary and frequently presenting a convex contour. The old acetabulum was found to contain some fat, but was chiefly occupied by an exceptionally large ligamentum teres, measur

ing 11⁄2 inches in length, 34 inch in width, and 3-16 inch in thickness, running from a well-defined cotyloid notch through the vertical diameter of the acetabulum to an insertion in the femoral head. As a rule the ligamentum teres had been found at the age of 3 or 4 years to be a mere ribbon, or to have disappeared. In the usual dislocation on the dorsum ilii the disappearance of the ligament might be explained by the facts that it had no function and was compressed closely between the margin of the acetabulum and the femur. In the specimen, however, the displacement had been directly upwards, and the tremendous size of the ligament was apparently the result of its being called on to sustain the weight of the trunk at every step in walking. Its great size, then, was physiological rather than pathological.

Dr. Whitman said that the old acetabulum appeared to be of fair size, and that as the tissues were doubtless far more yielding in life than in the preserved specimen, an operation by the open method, in which the hypertrophied ligament would have been removed, might have been successful.

Dr. Sayre said that as the head was as broad as, if not broader than, the place where the acetabulum should be, it was doubtful whether chiselling away a part of the head would not have been required before reduction.

TABETIC TALIPES VALGUS.

Dr. Judson presented a photograph of talipes valgus of the left foot in a man about 35 years of age affected with locotor ataxia of several years' duration. It was an instance of Charcot's joint affecting the tarsus. The patient's right knee joint had been exsected for this condition, but stability had not been restored to the knee by the operation. Pathologically there were pulpy and fluid degeneration of the bony and other tissues and disintegration of the structures of the joints. Equinovarus also occurred in locomotor ataxia and in Friedrich's disease, but was the result, not of bony changes, but of abnormal muscular action. The primary disease was so serious and disabling that the question of treating these secondary affections was not often a practical one. Mechanical treatment might, however, be

considered with three objects in view: 1, to give firmness to the foot and ankle and direct the sole to the ground; 2, to

give lateral support to a Charcot's knee; and 3, to stiffen the knees by the use of automatic joints in order to prolong the period when locomotion is possible with the aid of crutches.

Extracts from Home and Foreign journals.

SURGICAL.

A SIMPLE METHOD OF STERILIZING CATGUT.

Robson (Lancet, October 1, 1897) has been experimenting with the sterilization of catgut in fluids the boiling point of which is higher than water. He found xylol to be the most satisfactory. Catgut boiled in this fluid is better than that boiled in alcohol, for it shrinks, and thus gains in strength and "bites" better when tied. The exact method adopted is the following: The catgut is wound loosely from end to end round an elongated glass roel. Several of these glass reels are then introduced into a metal cylinder, the cap of which screws on, and after more xylol than is sufficient to cover them has been poured in, the cap is adjusted. The whole is then put into boiling water in the sterilizer and allowed to remain along with the instruments for from twenty minutes to half an hour. After thus being sterilized, the reels, with the catgut which has shrunk around them, are removed at once, and kept in either in five per cent. carbolic acid solution or in methylated spirit. the latter being preferable, as any aqueous solution tends to cause catgut to swell. In this solution they may be kept on the reels till required. The xylol should be used but once, as a certain amount of decomposition takes place, and the catgut will soften if heated in it a second time.

SOME VALUABLE SURGICAL HINTS.

The International Journal of Surgery for September, 1898, gives the following voluable hints: