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e completely ankylosed。
Infantile spinal paralysis is often the cause of distressing deformities； forbidding locomotion in the ordinary manner。 In a paper on the surgical and mechanical treatment of such deformities Willard mentions a boy of fourteen； the victim of infantile paralysis； who at the age of eleven had never walked； but dragged his legs along。 His legs were greatly twisted； and there was flexion at right angles at the hips and knees。 There was equinovarus in the left foot and equinovalgus in the right。 By an operation of subcutaneous section at the hips； knees； and feet； with application of plaster…of…Paris and extension； this hopeless cripple walked with crutches in two months； and with an apparatus consisting of elastic straps over the quadriceps femoris； peroneals； and weakened muscles； the valgus…foot being supported beneath the sole。 In six months he was walking long distances； in one year he moved speedily on crutches。 Willard also mentions another case of a girl of eleven who was totally unable to support the body in the erect position； but could move on all fours； as shown in figure 219。 There was equinovarus in the right foot and valgus in the left。 The left hip was greatly distorted； not only in the direction of flexion； but there was also twisting of the femoral neck； simulating dislocation。 This patient was also operated on in the same manner as the preceding one。
Relative to anomalous increase or hypertrophy of the bones of the extremities； Fischer shows that an increase in the length of bone may follow slight injuries。 He mentions a boy of twelve； who was run over by a wagon and suffered a contusion of the bones of the right leg。 In the course of a year this leg became 4 1/2 cm。 longer than the other； and the bones were also much thicker than in the other。 Fischer also reports several cases of abnormal growth of bone following necrosis。 A case of shortening 3 3/4 cm。； after a fracture； was reduced to one cm。 by compensatory growth。 Elongation of the bone is also mentioned as the result of the inflammation of the joint。 Warren also quotes Taylor's case of a lady who fell； injuring； but not fracturing； the thigh。 Gradual enlargement； with an outward curving of the bone； afterward took place。
CHAPTER XII。
SURGICAL ANOMALIES OF THE THORAX AND ABDOMEN。
Injuries of the lung or bronchus are always serious； but contrary to the general idea； recovery after extensive wound of the lung is quite a common occurrence。 Even the older writers report many instances of remarkable recoveries from lung…injuries； despite the primitive and dirty methods of treatment。 A review of the literature previous to this century shows the names of Arcaeus； Brunner； Collomb； Fabricius Hildanus； Vogel； Rhodius； Petit； Guerin； Koler； Peters； Flebbe； and Stalpart； as authorities for instances of this nature。 In one of the journals there is a description of a man who was wounded by a broad…sword thrust in the mediastinum。 After death it was found that none of the viscera were wounded； and death was attributed to the fact that the in…rush of air counterbalancing the pressure within the lungs left them to their own contractile force； with resultant collapse； obstruction to the circulation； and death。 It is said that Vesalius demonstrated this condition on the thorax of a pig。
Gooch gives an instance of a boy of thirteen who fell from the top of a barn upon the sharp prow of a plough； inflicting an oblique wound from the axilla to below the sternum； slightly above the insertion of the diaphragm。 Several ribs were severed； and the left thoracic cavity was wholly exposed to view； showing the lungs； diaphragm； and pericardium all in motion。 The lungs soon became gangrenous； and in this horrible state the patient lived twelve days。 One of the curious facts noticed by the ancient writers was the amelioration of the symptoms caused by thoracic wounds after hemorrhage from other locations； and naturally； in the treatment of such injuries； this circumstance was used in advocacy of depletion。 Monro speaks of a gentleman who was wounded in a duel； and who had all the symptoms of hemothorax； his condition was immediately relieved by the evacuation of a considerable quantity of bloody matter with the urine。 Swammerdam records a similar case； and Fabricius ab Aquapendente noticed a case in which the opening in the thorax showed immediate signs of improvement after the patient voided large quantities of bloody urine。 Glandorp also calls attention to the foregoing facts。 Nicolaus Novocomensis narrates the details of the case of one of his friends； suffering from a penetrating wound of the thorax； who was relieved and ultimately cured by a bloody evacuation with the stool。
There is an extraordinary recovery reported in a boy of fifteen who； by falling into the machinery of an elevator； was severely injured about the chest。 There were six extensive lacerations； five through the skin about six inches long； and one through the chest about eight inches long。 The 3d； 4th； 5th； and 6th ribs were fractured and torn apart； and about an inch of the substance of the 4th rib was lost。 Several jagged fragments were removed； a portion of the pleura； two by four inches； had been torn away； exposing the pericardium and the left lung； and showing the former to have been penetrated and the latter torn。 The lung collapsed completely； and for three or four months no air seemed to enter it； but respiration gradually returned。 The lacerated integument could only be closed approximately by sutures。 It is worthy of remark that； although extremely pale； the patient complained of but little pain； and exhibited only slight symptoms of shock。 The pleural cavity subsequently filled with a dirty serum； but even this did not interfere with the healing of the wound and the restoration of the lung； the patient recovered without lateral curvature。
Bartholf reports a case of rapid recovery after perforating wound of the lung。 The pistol…ball entered the back 1 1/2 inches to the right of the spinous process of the 6th dorsal vertebra； and passed upward and very slightly inward toward the median line。 Its track could be followed only 1 1/4 inches。 Emphysema appeared fifteen minutes after the reception of the wound； and soon became pronounced throughout the front and side of the neck； a little over the edge of the lower jaw； and on the chest two inches below the sternum and one inch below the clavicle。 In four hours respiration became very frequent； short； and gasping； the thoracic walls and the abdomen scarcely moving。 The man continued to improve rapidly； the emphysema disappeared on the seventh day； and eighteen days after the reception of the wound he was discharged。 There was slight hemorrhage from the wound at the time； but the clot dried and closed the wound； and remained there until it was removed on the morning of his discharge； leaving a small； dry； white cicatrix。
Loss of Lung…tissue。The old Amsterdam authority； Tulpius； has recorded a case in which a piece of lung of about three fingers' breadth protruded through a large wound of the lung under the left nipple。 This wound received no medical attention for forty…eight hours； when the protruding portion of