muscle that seemed to contract with energy in walking was the vastus externus. An indistinct transverse groove was felt above the patella^; but it was impossible to say how far the connection between the muscles and the patella had suffered. The motions of the joint were quite free, and the patient only complained of a slight limp in walking.
Dr. C. remarked that Malgaigne had collected twenty-five cases of outward dislocation of the patella, and had seen two ; Dupuytren had seen three ; Boyer one ; Sir A. Cooper one, and Liston none. 1866.
Dr. Algernon Coolidge.
1190. Cast of the foot, from a case of dislocation of the astrag- alus.
The patient was a man seventy-eight years of age, and the injury was occasioned by a fall when he was eight years old. He had always had pain, with lameness, and an en- largement of the ankle. After his death Dr. F., with per- mission of the family, went to Portland, Maine, and removed the foot. The cast was then taken, and the foot prepared by Dr. F. ; (No. 1191.) 1869.
Dr. Wm. C. B. Fifield, of Dorchester.
1191. The tarsal bones, with a portion of the bones of the leg preserved in connection from the last case, and showing the following appearances : The astragalus is entirely sep- arated from the os calcis, except to a small extent, as seen posteriorly ; retains its proper relations to the tibia, but is turned inward to an angle of about 45, so that its anterior rounded head is not one-half covered by the scaphoid bone, though there is a very considerable projection inward of this last, as if for the purpose of retaining the articulation. The os calcis, just behind its articulation with the cuboid bone, shows a large and very marked articular surface, and there is a corresponding one upon the very lower extremity of the fibula. There is a little twist of the tibia, induced by the inward revolution of the astragalus. Lower extrem- ity of the fibula much enlarged, and directly in front of its articulation with the os calcis is a growth .of new bone as large as the last joint of the finger. This last is discon-
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