Calendar: 1882-1883 Page 697

694 MEDICAL DEPARTMENT Describe the separate operations which are performed for the removal of calculus Illustrate some of these points by reference to the patient Scriven now in the Fisk Ward Give sketch of the circumstances which rendered it difficult to decide what operation should be performed Describe with minuteness the operation which was performed and mention the peculiar features of the case II Describe the symptoms of case of chronic arthritis of the knee joint terminating in incurable injury to the articulation Mention the individual structures which may be primarily and secondarily attacked and describe the changes which they undergo in the degenerative process State in detail the symptoms which attend upon these changes Give sketch of the treatment which should be adopted at various stages of the disease and describe the means by which reparation is produced in some cases and how such reparation when taking place is ultimately prevented Describe the operations which may be needful in certain instances and refer to cases which have been in the hospital in Professor Smith's wards this session which illustrate these points II -Ca3e in burger for Commentarj healthy young man engaged on an engine was struck on the knee by buffer with great violence He was conveyed to bed and on examination there was no external wound neither was there any alteration in the figure of the joint or any crepitus to be felt few hours afterwards he complained of great pain and at the expiration of twenty-four hours there was considerable swelling of the knee This increased and there was great tension and much heat of skin The con- stitutional disturbance became severe there was great fever headache and thirst much pain in the joint and disturbance of sleep These symptoms continued and at the end of ten days on examination of the joint distinct grating could be felt consultation was now held as to the necessity of