166 MORBID ANATOMY.
at his trade since August, and without inconvenience. The arm was perfectly firm, and free from pain; and the extensors of the wrist and fingers had recovered the power of motion perfectly.
The union of the musculo-spinal nerve, Dr, B. regarded as a point of great interest. (Med. Jour. Vol. LXXVI. p. 329.) 1868. Dr. H. J. Bigelow.
1008. A fourth case. Portions of bone removed at two different times.
The patient, a soldier, received a gun-shot wound about the middle of April, 1862. The humerus having been shattered about midway, the fragments were at once removed, and the ends of the bones sawed off and approximated. At the end of six months no union had taken place; and the ends of the bones having been again sawn off, were wired together. In two weeks the wire was removed. There never was any union, and when he entered the hospital (125, 22) Nov. 3d, 1865, there were several fistulas, the bone could be felt, and a few small pieces had been discharged. The arm swung freely in all directions, but there was no pain; and the general health was excellent.
Nov. 4th an incision was made over the lower fragment, upon the outside of the arm, and the sinuses were found to extend down into the interior of the bone. The cavity in this last was then exposed throughout by the removal, by the trephine, of three pieces of bone, and the interior was thoroughly scraped with a gouge. The periosteum was scraped back, and a portion of the lower fragment was removed. This last was 2½ in. in length, 1½ in. in diameter, and changed in structure, as well as enlarged, by chronic inflammation; irregularly pointed toward the extremity, and shows the course of the sinuses as they extended down into the interior of the bone. The periosteum was then scraped back from the upper fragment, which was healthy, though not more than one-half its natural size, and quite pointed. A few points were nipped off; the end fitted into the cavity in the lower fragment, and the two wired together. Splints were applied so as to keep
