end of about a week the patient left the bed, and could walk about, but, of course, with a stiff leg. He wore this splint or cap for the knee for about four weeks, when I found he could leave it off at night without much pain. Continued to wear it during the day for perhaps a fortnight, when I found he could leave it off entirely.

I mention this case partly for the purpose of calling the attention of the members of the society to the use of gutta percha as a material for splints. It is not adapted to all cases of fracture; but in very many cases I find nothing else so satisfactory. I have thought that in fracture of the patella it would be peculiarly valuable, as it is so readily adjusted to all the inequalities of the knee joint.

Case Second.—Jerome De——, aged fifty-four years, native of France, single, was admitted to the Santa Clara County Hospital, July 20th, 1878. He was suffering from rheumatism, or at least complained of pains in various parts of the body, more particularly the long bones of the arms and legs. These pains were worse at night, pulse varying between 80 and 90, temperature natural. Suspecting a specific origin for this malady, I put him on the use of iodide potassium, with increasing doses. He slowly improved with the exception of a pain in the left humerus, anteriorily, and in the upper part of the middle third. This became localized to a spot no larger than a twenty-five cent piece. At times the pain was intense and excruciating: and about a week from admission this spot seemed quite tender to the touch. After the use of a blister and tincture of iodine for a week, he was somewhat relieved. Not entirely, however, for at times the pain was very severe. On Aug. 7th, he left the hospital thinking he could do some work. The next day, while attempting to climb a fence, and while in the act of raising the body by the arms, the left humerus was fractured transversely at the exact point of his previous suffering.

He was again admitted to the hospital, and the fracture dressed in the usual manner. After five or six days a gutta percha splint was used which encircled the arm. Bony union was slow in taking place. However, on Oct. 3d, nearly two months from the date of the fracture, he left the hospital, the union being complete, and he being entirely relieved from his pain; in fact, he was relieved from the moment of the fracture.

This case presents a question in pathology which is of interest. Was there a localized periostitis at this point? If so, why was it not entirely relieved by the treatment which consisted of blisters and iodine, externally, and mercury and iodide potassium internally? Was there a deficiency of nutrition at this point? or anemia from some change in the nutrient artery,—the result of the periostitis of the long bones? Or was it incipient necrosis? Prof. Hamilton gives the record of a case of fracture of the humerus, from muscular action, taking place three several times in the same individual, each time in a different place.

Case Third.—Dec. 29th, 1878, was called to see Mr. ——, male, married, aged about 40 years. Has led an out-door, active life. Has always been healthy. No venerial taint. Nervous temperament, spare built, and weighs about 140 pounds. Present condition: Has been sick two or three days; the attack commenced with a chill, followed by fever; has had fever ever since the chill; complains of pains in the back and legs; has vomited considerable; bowels costive; tongue coated; severe pain in right side corresponding to lower part of the lung, which I found solidified; there is considerable cough.

Ordered a cathartic; to be followed by an anti-pyretic of acetate of ammonia and aconite, and a blister over the lower part of the right lung. Continued this treatment for three or four days, when the