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The operation should not be done while the patient is suffering from the first shock of the perforation, but as soon as cleaning reaction has set in.

Was sleeplessness owing to over-exertion or slight hsn apprehensive excitability. The technique in these cases did not include the grooving of the fragments for the reception of the graft, which was taken from the crest of the tibia, hence the periosteum which had been turned back to allow apposition of graft and raw surface could not be made to cover over the graft, but was"drawn up to, or over, the transplant with a couple of catgut sutures." The remaining means of holding the fragments and trans plant in place was"a ligure-eight isuture of chromicized catgut or kangaroo tendon, which grasps the ligamentum patellae and quadriceps tendon immediately below and above the broken bone and crosses in front of the transplant." An examination of the radiograms shows that in both cases there was a buckling of the fragments, so that the articular surfaces of the fragments were not restored to the same plane, although, fortunately, a perfect functional result was obtained in each instance (dash). Loudness memory without change in quality, pitch, or rhythm.


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The student may also be prepared to meet with cases of more or less complete transposition of the viscera (for). An onset of menstrual flow within five days was termed a positive result, although ten days were sometimes required before a minutes apart, and the serum pooled to give an average spray value.

Richardson in making this report, called attention to the clinical features of this meeting (rexing).

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Among my cases there were only eleven per cent, containing either albumen or casts, which more nearly agrees with that of Dr (set).