Dr. Keetley thought Dr. Clarke could hardly have chosen a more interesting subject, undoubtedly, the Bone-setter frequently earned great credit by the manipulations which broke down adhesions outside a joint, and at the same time, removed the cause of inflammation, for in these cases there was no contraction of membrane. When there was an osseous fibrous hand the case was of a strumous origin, it was due to the presence of organisms. In such cases the joints became altered, and there was great danger from the rough usage of the Bone-setter. In the treatment of such joints he had put on ice for several days with great advantage, and had repeatedly put them straight. When once convalescent, a joint very rarely became strumous. There was much bewilderment with regard to the value of rest, which was only a negative factor. It was the natural tendency of a column of germs to die as the joint became healthy. Dr. Alderson related the case of a knee which became enlarged fourteen days after confinement, but without pain. He called in Dr. Hewitt who ordered rest, and the knee to be rubbed with salad oil. He also used Scott’s dressing. Subsequently, at Brighton, a sea-weed poultice was used. The treatment was successful. Dr. Alden Owles had seen several cases confirmatory of the opinions advanced in the paper. Once was a shoulder, the manipulation of which caused agony to the patient, but in which motion was regained. Another regarded at first as a strumous joint was eventually cured by somewhat violent manipulation. Dr. Vinen referred to the case of an officer of the 60th Regiment, who sustained a compound fracture below the knee whilst playing at football in India. The bones were set by some naval surgeons who were watching the game; but in consequence of the leg being deformed, the adhesions were broken and the limb reset. The ankle then remained fixed, and the patient’s health suffered. However, Mr. Erichsen was called in, broke the adhesion, and the patient recovered so thoroughly, that he was enabled to rejoin his battalion in the Transvaal. Dr. Bruce Clarke in reply, pointed out the necessity of distinguishing chronic cases, as such were usually made worse by movement. In the course of this discussion only one point of the Bone-setter’s practice was alluded to—that of rigid or strumous joints, as if the renown of the Bone-setters art rested on these alone. “There are none so blind as those who will not see.” [Illustration: PLATE VI.—FRACTURES. 25. Fracture of humerus. 26. Fracture of ulna. 27. Colles’ fracture. 28. Compound fracture of leg (tibia and fibula).] CHAPTER VI. _DISPARAGEMENT AND VINDICATION._ “Who shall decide when doctors disagree?”