nt,
say up to the elbow and the ankle, with very great accuracy. Thus,
Figure 8 shows the deformity from an old fracture of the ulna (one of
the bones of the forearm) very clearly.

By this means we shall be able to distinguish between fracture and
dislocation in obscure cases. Thus Mr. Gray ("British Medical Journal,"
March 7, 1896), in a case of injury to an elbow, was enabled to
diagnosticate and successfully to replace a very rare dislocation, which
could not be made out by manipulation, but was clearly shown by the X
rays. We may also possibly be able to determine when the bones are
properly adjusted after a fracture; and all the better, since the
skiagraph can be taken through the dressings, even if wooden splints
have been employed. If plaster of Paris is used (and it is often the
best "splint") this is impermeable to the rays.

That this method will come into general use, however, is very unlikely,
since the expense, the time, and the trouble will be so great that it
will be impracticable to use it in every case, especially in hospitals
or dispensaries, where crowds of patients have to be attended to in a
relatively brief time. In the surgical dispensary alone of the Jefferson
Medical College Hospital, about one hundred patients are in attendance
between twelve and two o'clock every day, and all the time of a large
number of assistants is occupied with dressing the cases. It would be
manifestly an utter impossibility to skiagraph the many fractures which
are seen there daily, considering that it would take from half an hour
to an hour of the time of not less than two or three assistants skilled
not only in surgery, but also in electricity, to skiagraph a single
fracture. Now and then, in obscure cases, however, the method will be
undoubtedly of great service, as in the case above described.

[Illustration: FIGURE 7.--SKIAGRAPH OF A BABY'S SKULL, SHOWING TWO
BUCK-SHOT PLACED UNDER THE SKULL.

("American Journal of the Medical Sciences," March, 1896.)]

Too hasty conclusions, especially in medico-legal cases, may easily be
reached. We do not yet know, by skiagraphs of successful results after
fracture, just how such bones look during the process of healing, and,
therefore, we cannot yet be sure that the skiagraph of an unsuccessful
case is an evidence of unskilfulness on the part of the surgeon.

In diseases of bone, which are obscure, it has already proved of great
advantage, as in a case related by Mr. Abr