the leg. There was but very little pus discharged from this opening
afterward, not, however, for want of drainage, since the cut was kept
open by introducing the probe occasionally. About the 9th or 10th of Feb.
fluctuation became quite apparent along the outer and lower part of the
thigh. On Feb. 12th, consultation was again had, when fluctuation being
very well marked over a considerable portion of the thigh in its lower and
middle thirds, after giving the patient chloroform, an incision was made
three inches long on the outer and posterior part of the thigh, from
the junction of the lower with the middle third, downward through the
posterior part of the vastus externus muscle. About two quarts of laudable
pus was discharged. By introducing the finger upward and downward, the
periostium could be felt smooth except within the knee joint, for this
could be distinctly felt, the finger passing readily between the ends of
the femur and tibia, and beneath the patella; the crucial and lateral
ligaments seemed to be gone, and the cartilages somewhat roughened. A
drainage tube was put in, the leg bandaged from the toes to the trochanter
major, with compresses so arranged as to obliterate the sack, if possible.

The patient, up to this time, had been slowly losing flesh, and was now
very much emaciated. A general typhoid condition existed, the temperature
ranging from 101 to 103.5; the pulse from 115 to 135, tongue coated, poor
appetite, and in short, the patient in a very critical condition. The use
of chloroform, and the shock from the evacuation of the pus, added to the
gravity of all the symptoms, and for about two weeks the patient was in
great danger of death from asthenia. However, by liberal use of whisky,
quinia, beef tea, cod liver oil, etc., he slowly rallied. Two smaller
abscesses formed below the knee, but those gave no great anxiety, not
so much as some bed sores on the back and hips. The sack or pouch became
gradually obliterated, down as far as the knee. The cavity of the joint,
however, did not seem to be well drained from the opening in the thigh,
notwithstanding it had been kept open freely by tents. About three weeks
from this last operation, the sinus or pouch within the knee-joint being
so imperfectly drained as above indicated, I made an opening directly into
the joint at the outer and posterior part, one inch long, through which I
could introduce the probe between the ends of the femur and tibia, without