19. In such a case, then, the extirpation of the astragulus is the expedient to be preferred. What, indeed, are its inconveniences? 1st, An inevitable anchylosis of the foot and leg: 2dly, a shortening of the affected limb. But a leg even in this state, is still better than a wooden leg, which is the necessary consequence of amputation: besides, a leg of the former description occasions no great inconvenience in either walking or standing, whereas one of the latter, produces extreme lameness: in the first case, a heel on the affected side somewhat higher than that on the other, is an easy method of removing the deformity. What, then, are such trifling disadvantages, when compared with the evils which they ward off? The extirpation of the astragulus is accompanied with but little pain. The want of this intermediate body between the leg and the foot, by producing a relaxation of the surrounding soft parts, prevents pain and swelling in such cases: should abscesses supervene, they will not, if properly treated, greatly retard the cure. In a word, experience coincides with this doctrine. Desault has seen it twice verified in the practice of other surgeons, and three times in his own. I have known of but one case of the kind, in which the termination was fatal, and there, a malignant fever, induced by the contaminated air of the hospital, certainly contributed to the death of the patient, which did not occur till two months after the reduction. CASE VI. Desault usually gave in his lectures, the history of a case where the success of this practice was remarkable. A man was brought to the Hotel-Dieu, with a luxation of the foot, complicated with a fracture of the lower part of the leg, and a laceration of the ligaments and capsule, through which the astragulus had escaped by a luxation forward and upward, so as to have half of its anterior surface exposed. The extent of the injury seemed to call for amputation. But the youth, the vigour, and sound constitution of the patient, gave ground to hope that a process less desperate might succeed. The astragulus, already separated anteriorly, was extracted by dividing the attachments which held it to the os calcis, and the bones of the leg: the reduction was then effected without difficulty. The parts being replaced more readily in consequence of the removal of this bone, were retained so by means of a bandage similar to that for fractures of the leg, but modified so as to suit the particular case. The patient lost blood once or twice: the apparatus was kept constantly wet; a very strict regimen was prescribed for some days; but few troublesome symptoms occurred; a slight swelling took place, but was soon removed; a favourable suppuration came on; the dressing was renewed twice a day; some splinters escaped occasionally; several abscesses formed successively were opened, and healed up again: the wounds themselves closed, and the patient finally recovered, with an anchylosis, indeed,