PREFACE. DURING the past few years literature on the Röntgen ray has grown to large proportions. It has led to many and revolutionizing discoveries; most of these have marked a clearer understanding, and consequently the better treatment, of fractures. Still, publications on this subject hitherto have not claimed to be more than tentative sketches or preliminary communications. This book is an effort to encompass in a systematic treatise the important essentials of the publications on this subject and such individual studies and experience as it has fallen to my lot to make. In these studies the Röntgen ray has verified the anatomic findings. It did so by exposing the fractures in their living state. The illustrations in older works were mainly made from the cadaver. The splendid schematic representations that resulted were not portraits from life. The minute arrangement and disarrangement of fragments and splinters, especially in their relations to the joints, were necessarily disarranged by even the most careful dissections. The Röntgen ray depicts these details and all others undisturbed and as they are in life. It is with these that the surgeon has to deal. Before Röntgen's epoch-making discovery it was just and proper to associate all studies of fractures with those of dislocations. The essential aim of this association necessarily was for purposes of differential diagnosis. Now, however, the student, made familiar with the various types of fracture, has no difficulty in recognizing and appreciating the various forms of dislocation. Moreover, the greater importance of the former is evident in the fact that fractures occur no less than 196211 ten times as frequently (a longer experience with the Röntgen ray will probably make it fifteen times) as do dislocations. Furthermore, the after-treatment of fractures must be predicated upon a thorough recognition of the anatomic relations of the line of solution of osseous continuity, while in dislocations the therapy after reduction is very simple. Necessarily, the differentiation of the more frequent luxations, that closely resemble fractures, has received considerable attention in these pages. All the common, and some of the rarer, types of fracture are represented skiagraphically. The skiagrams and most of the drawings here presented are originals. They depict cases observed and treated in my dispensary, hospital, and private practice. Some illustrations are copied from Hoffa, von Bergmann, Ollier, Nélaton, and Lejars. The skiagrams are exact reproductions of photographic prints. I resisted the temptation to emphasize their essential points by artistic interference, so that they represent the skiagraphic findings precisely as they are, with the exception of figures 107, 122, 151, and 169, in which the important points were lost during the process of reproduction. Figure 75 is treated schematically. It affords me special pleasure to here thank Professor Röntgen for the many kindnesses of which I have been the recipient at his laboratory. My sincere acknowledgments are also due to Professors von Bergmann and Koerte, to SurgeonGeneral Stechow, of Berlin, and to Professors Hoffa and Gocht, of Würzburg, for many courtesies. The skiagraphic plates were developed by Mr. Joseph Byron, whom I desire to thank for his painstaking work. It also affords me pleasure to acknowledge my obligations to the publishers, W. B. Saunders & Company, for the typographic and pictorial excellence of this book. 37 East 31st Street, New York. CARL BECK. INTRODUCTION. FEW Scientific discoveries of the century have astonished the world more than that reported by Wilhelm Conrad Röntgen, of Würzburg-on-the-Main. The significance of this great discovery can not even yet be estimated. The preparatory researches that led to this discovery date from the time when Maxwell, extending and applying Faraday's theories, found that the phenomena of electricity depend upon the same principles as those of light. Both consist in vibrations of the ether that pervades the universe. Wiedemann, Verdet, Kundt, Gassiot, Spottiswoode, and Röntgen tried to prove that the phenomena of electricity are in close connection with those of light, and not only that electricity could produce light, but also that light could produce electricity. The correctness of these theories, however, could not be proved until the experiments of Wilhelm Hertz, a professor at the University of Bonn, brought conviction to the minds of even the most skeptical. Hertz showed that electric induction obeys the same laws as those governing the diffusion of light-waves. He also determined the speed of transmission of the electric wave, which he found to be equal to that of the light-wave. The phenomena of electric discharge in closed tubes, showing various degrees of exhaustion and filled with |