#Old-standing Dislocation of the Shoulder.#--It is impossible to lay down definite rules as to the date after which it is inadvisable to attempt reduction by manipulation of an old-standing dislocation of the shoulder. Experience of a hundred cases in Bruns' clinic led Finckh to conclude that, provided there are no complications, reduction can generally be effected within four weeks of the accident; that within nine weeks the prospect of success is fairly good; but that beyond that time reduction is exceptional. The patient is anæsthetised, and all adhesions broken down by free yet gentle movement of the limb. The appropriate manipulations for the particular dislocation are then carried out, care being taken that no undue force is employed, as the humerus is liable to be broken. If these are not successful, they should be repeated at intervals of two or three days, as it is frequently found that reduction is successfully effected on a second or third attempt. Should manipulative measures fail, it may be advisable to have recourse to operation if the age of the patient and his general health warrant it, and if the condition of the limb is interfering with his occupation or involves serious disability. If operation is deemed advisable, a few days should be allowed to elapse to permit of the parts recovering from the effects of the manipulations. The joint is freely exposed, the capsule divided, the head of the bone freed and returned to the glenoid cavity. It is sometimes so difficult to replace the head of the bone that it is necessary to resect it and aim at the formation of a new joint, an operation which usually yields satisfactory results. #Habitual or Recurrent Dislocation.#--Cases are occasionally met with in which the shoulder-joint shows a marked tendency to be dislocated from causes altogether insufficient to produce displacement under ordinary circumstances. This condition is usually met with in young women, and, in some cases at least, appears to be due to too early and too free movement of the joint after an ordinary dislocation, so that the capsule is stretched and remains lax. In some cases it would appear that the liability to dislocation is due to some structural defect in the joint, and under these conditions both sides are sometimes affected, and the accident is not attended with the usual pain and disability either at the time or after reduction. The facility and frequency with which dislocation recurs render the limb comparatively useless, and may seriously incapacitate the patient. We have had cases under observation in which dislocation resulted from the hyper-abduction of the arm in swimming, from throwing the arms above the head in dancing and in gymnastic exercises, and even in "doing" the hair.