in which the arm, scapula, and, in some instances, portions of the clavicle were torn away from the body entirely, the surgeon only dressing the resulting wound, all the cases making a prompt recovery, the youngest one being only seven years of age. Have a second table, also eleven cases, in which the arm, scapula, and sometimes portions of the clavicle were removed by the surgeon, the cause being extensive injury of the parts, or diseased tissues. Out of this number only one died of shock, due evidently to the low vitality of the system, indicated by fatty degeneration of the heart, liver and kidneys; the other ten cases surviving the operation. Of those ten only two died from a recurrence of the disease. Have a third table giving fifteen cases, in which the scapula, and sometimes portions of the clavicle, were removed as a secondary procedure after the arm had been amputated at some previous time. One of the cases died seven days after the operation, and second fourteen days after the operation, and a third died shortly after the operation from a recurrence of the disease, the remaining twelve cases recovering for an unknown length of time, of one stated thirty years. And a fourth table might begin as that of S. Rogers, in The American Journal of the Medical Sciences for 1868, in which he reports nine cases in which the entire scapula, and sometimes portions of the clavicle, were removed, and still retain a fairly useful arm. This table certainly gives a good showing in favor of conservative surgery, and has been fitly named by Sir Wm. Ferguson, the "ne plus ultra” of conservative surgery. There are undoubtedly more cases recorded, but this is all the literature on hand afforded. I am under especial obligation to H. C. Lea's Son & Co. for sending me The American Journal of the Medical Sciences for 1868, which contained the classical article of S. Rogers, above referred to; also had reference to an article by W. J. Conklin in the same journal for the year 1883. TABULAR STATEMENT OF ACCIDENTS BY WHICH THE ARM AND SCAPULA WERE TORN AWAY FROM THE BODY. Recovered No bleeding of importance; no ligatures were Girl 11 years of age; well and discharged in 2 Boy 16 years. Amount of blood lost estimated Arm and scapula torn away Recovered No hemorrhage of consequence took place; no ligatures were applied. Boy was well in 9 weeks. Secured the vessel by ligature; although there Recovered No bleeding, but as a precautionary measure the subclavian was tied. moved, outer of clavicle Recovered There was little bleeding and little shock. Boy TABULAR STATEMENT OF OPERATIONS INVOLVING THE REMOVAL OF THE ARM, SCAPULA, AND SOMETIMES PORTION OF THE CLAVICLE IN ONE OPERATION. Recovered A man of 40 years. Was in good health some Died of This unfortunate termination was probably in- TABULAR STATEMENT OF OPERATIONS INVOLVING THE REMOVAL OF THE SCAPULA AND SOMETIMES THE CLAVICLE IN PART, AS A SECONDARY PROCEDURE AFTER THE ARM HAD BEEN PREVIOUSLY AMPUTATED. SOME RECENT EXPERIENCES IN CLINICAL SURGERY. (Illustrated by Notes of Cases, Pathological Specimens, and Patients). BY DONALD MACLEAN, M. D. The first subject to which I desire to call the attention of the Association is the common one of diseased knee joints. Two cases have recently occurred in my public practice which have seemed worthy of presentation here, for the reason that they represent in a practical manner two important pathological conditions, demanding widely different methods of treatment, viz: in the one resection of the joint, in the other amputation of the thigh. A pathological specimen obtained from each one of these cases I have brought with me for inspection by those members of the Association who may feel an interest in the subject. Not only so, but one of the patients, viz., the one in which resection was performed, is present in the flesh for the purpose of giving ocular demonstration of the result of his treatment. Case 1. Charles M., æt. 19, Alpena, Mich., Englishman. History about seven years ago, patient says that he had his left knee bruised between two logs. Notwithstanding the use of liniments, plasters, blisters, etc., the effects of this injury per sisted, and the joint grew steadily worse until August, 1884, when patient came to the University hospital at Ann Arbor, where Dr. Sullivan, in my absence, examined the knee and applied a plaster of Paris cast. From this the patient states that he experienced great relief. On October 10th following, patient returned to the hospital and was examined by myself. The symptoms at that time |