. Wisconsin medical recorder . ractured surfaces. Consequent to thefracture and to the disability which itentails, there develops a retraction andan atrophy of the quadriceps extensor femoris. This muscular contraction,this muscular atrophy, is the most im-portant cause of the great difficulty attimes almost insurmountable, which weencounter in our endeavors to approxi-mate, to appose, to reunite the bony frag-ments. As easy as is the primarysuture of a fractured patella, just asdifficult can be the suture of an oldfracture of the patella. It is convenientfrom the operative standpoint to class
. Wisconsin medical recorder . ractured surfaces. Consequent to thefracture and to the disability which itentails, there develops a retraction andan atrophy of the quadriceps extensor femoris. This muscular contraction,this muscular atrophy, is the most im-portant cause of the great difficulty attimes almost insurmountable, which weencounter in our endeavors to approxi-mate, to appose, to reunite the bony frag-ments. As easy as is the primarysuture of a fractured patella, just asdifficult can be the suture of an oldfracture of the patella. It is convenientfrom the operative standpoint to classi-fy old fractures of the patella into:— A. Those in which the fragments canbe approximated with but little difficul-ty. B. Those in which owing to the co-existing atrophy and unusual retractionof the quadriceps extensor femoris mus-cle the approximation or rather theexact apposition of the fragments is adifficult feat to accomplish. (To be continued). * * A NOVEMBER SUGGESTION Original Sketch Drawn by Grace M. Norris, M. Every Bird Has His Day STUDIES IN ITALIAN THERAPEUTICS BY WILLIAM WAUGH, M. D., Chicago, Illinois The medical profession is over-abun-dantly supplied with surgeons, fairlywell with accomplished diagnosticians,and occasionally develops a therapeu-tist, a clinician. Such a one was Trous-seau; and his great work on ClinicalMedicine was followed by a swarm ofclinical studies, many of intestimablevalue. Felix Von Niemeyer was a clin-ician also, combining the faculties of anacute observer with those of a logician,his reasoning being a monument ofsound ratiocination based on profoundknowledge of the subjects was also a scholar, a clini-cal observer and a student of nature. Hesaw clearly the difficulties under whichthe profession labored, groping blindlyin the bogs, from which the medievalmists had not yet lifted; and he showedus that one firm footing must be securedbefore we could take a step he supplied in the adoption of rem-e
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