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PROCEEDINGS OF SOCIETIES. 443 NEW YORK ACADEMY OF MEDICINE. SECTION IN SURGERY. Meeting of March 11, 1889. Dr. Robert Abbe in the Chair. An Operation on the Os Calcis. — The Chairman presented a patient who, four years before, had received a lacerated wound in the heel by which a portion of the fleshy substance of its inferior surface was destroyed. A large and painful cicatrix had formed at the site of the injury, and walking had given the patient constant and severe pain, evidently due to the impact of the cicatrix against the rounded knuckle-like projec- tion of the plantar surface of the calcaneum. As a ])lastic op- eration had been out of the question, it had occurred to him that relief might be obtained by sawing away a portion of the bone so as to obtain a perfectly flat surface motrin ad inferiorly ; this had accordingly been done ; primary union had been obtained, and the patient was now able to walk on the heel thus flattened out without inconvenience. Hysterical Monoplegia in a Male.— The Chairman also presented a young man about twenty-five years old in whom this condition was developed, the mild clonic spasm and its occurrence in motrin gel a male patient making the case an uncommon one. This patient had fallen and struck motrin eq on his back on a slip- pery pavement, had felt a sharp pain, and had at once lost full power to use the right leg. From this time on this limb had been affected with anaesthesia, the motrin pm coupon gait had been irregular, and if the patient lay down and moved the limb about, a clonic spasm appearing like an exaggerated tremor was at once pro- duced. Any general effort produced violent trembling due to clonic spasm in the muscles of the neck and abdomen, and partial stoppage of respiration. Exquisite sensitiveness was complained of when a portion of the spinal column opposite motrin 500 mg the first dorsal vertebra was pressed with a piece of ice. How- ever, the anaesthesia was diminishing, and when ether had been given, though the affected limb had remained weak while the patient was going under its influence, as he was coming out it had been used with the utmost vigor. It had become quite evident that the case was largely hysterical in its nature when it was also found that by suggestion the patient extra strength motrin could be made to complain of the same pain in any portion of the spinal col- umn touched with the ice as that which he had first felt. On being forced to run along the wards quite rapidly, he had used the affected limb freely and had not stumbled. Mild clonus was a rare affection, and had not been classified among any of the diseases of the nervous system. The monoplegia did not suggest a spinal paralysis. The condition motrin 500 present was probably then a hysterical neurosis, perhaps due to shock, and existing without motrin 100 mg the patient's being conscious that bis own ideas were so largely the cause of it. Modified Tracheotomy.— Dr. D. B. Delavan called atten- tion to an expedient by which the ordinary operation of trache- otomy could be made much motrin printable coupon more satisfactory in its result to the patient. He had published an account of it several years ago, and had since used it repeatedly in his own practice to great advantage, but no notice of it had been taken by any one else in the profession. The modification consisted in making a round opening in the trachea where it was desired to insert the cannula, cutting out with a small, sharp tenotomy knife a portion of two or 800 milligram motrin more of the tracheal rings at once, instead of making a vertical slit and forcing the cannula through motrin commercial it. Several difficulties and accidents that sometimes occurred might motrin 18 be avoided in this way. The risk of making a false passage in inserting the can- nula was entirely removed. Bulging forward of the fibrous tissue completing the tracheal tube posteriorly when the rings were flattened from in front in forcing in the cannula after the ordinary operation, and which had caused occlnsion of the pas- sage and death, was entirely prevented. The irritation and soreness in the edges of the distended parts, which usually con- tinued for several days after the ordinary method had been followed, were thus obviated. When we considered that when a cannula was left in place for a few weeks the parts which the whats in motrin cannula pressed upon were absorbed and the opening became perfectly round, motrin gel caps it would seem quite without objection to make such an opening at once. The method was particularly appli- cable for this reason in conditions, such as cancer and syphilis, where the cannula must motrin b be worn for a considerable time. motrin products It could cvs motrin be withdrawn and returned without diflaculty from the first, and without the use of dilators. Granulations, malignant or other, would not spring up in the tissues about the cannula, as so often happened when a vertical incision was made. Subluxation of the Head of the Radius, with a Resume of One Hundred Consecutive Cases.— Dr. W. W. \'an Ars- DALE read a paper with this title, beginning with a clinical de- scription of the injury and a comparison of the various theories held by different writers to account for the occurrence and pe- culiar symptoms of this lesion. His conclusions were as follows: 1. The injury frequently occurring in children and called subluxation of the head, or motrin discontinued displacement by elongation of the radius, is a well-defined sur- gical injury with well-marked constant symptoms and due to the same anatomical lesion in each case. 2. In frequency motrin 1000mg it makes one per cent, and over of the surgical injuries occurring

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