Board decided that lie should be returned to iiud ordered to wear a knee-cap. The history of the accident which caused the injury is, that in August 1889, lie slipped down a bank when he states he felt a " bone It gave him come out" in his right knee. for some to move the time, but great pain joint eventually the " bone" went back. When it was out, he states he could feel the "bone" from the outside, and some of his comrades also felt it. The joint was swollen for a time, and he received treatment in hospital. He again came to hospital, 3rd November 1890, and stated he was hardly able to walk; he then appeared very lame; he now stated that the " " bone came out and went back again, when he bent the knee, and that it could be felt from the outside, also that it sometimes came out when he was standing still. The joint had been examined by several medical officers, none of whom could detect the loose body, or indeed anything abnormal. The fact, however, of the man's lameness was obvious to all. Since the of the accident to his knee in occurrence August 1889, he was seventeen days in hospital in Bareilly for contusion of knee-joint, the result of a fall, 22nd November 1889, and thirteen days in hospital in Ranikliet, 8th August 1890. On the last occasion, viz., 3rd November 1890, he remained forty-six days under treatment before being brought forward invalid. After his appearance before an as the Board, just one year since, he wore an elastic knee-cap which appeared to enable him to do his duties without inconvenience, for, till recently, nothing was heard of him. On December 25th last he came to hospital aa already stated, suffering from acute dysentery which terminated fatally. When the right knee-joint was opened, the internal semi-lunar cartilage was found split in the centre, the rent or tear being about f inch in length, and parallel to its inner border. The inner ribbonlike portion of cartilage was twisted ; the inner margin of the ribbon becoming the outer. The segment was also relaxed and elongated, so that it could be pushed into a shallow fold. Doubtless, the movements of the internal condyle of the os femoris caused this narrow relaxed ribbon of cartilage to twist and untwist, and to fold and unfold which might give rise to the feeling of a loose body in the joint. This form of injury is uncommon, and is interesting as shewing how the subjective symptoms of " loose body in the knee-joint" and subluxation may be simulated by an entirely different pathological condition due to injury, since, in this case there were the recurring attacks of pain on movement, the feeling that a loose body was present and recurring attacks of synovitis. The palliative remedy of a kneecap was also found of great service here,

duty,

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RUPTURE OF THE INTERNAL SEMI-LUNAR CARTILAGE OF THE KNEE-JOINT. By Surgeon-Major J.

STEVENSON,

M.B., D.S.O., F.R.C.S., EDIN.

I venture to think the following notes of case of injury to the knee-joint may prove interesting enough to be worth placing on It is not always we have an opporrecord. tunity of inspecting the actual condition of an injured joint when the history of the case was so well known during life in the less important a

lion-fatal injuries. No. 1858, Private W. P., 1st Battalion, Rifle

admitted to the Station Hospital, 25th December 1891, suffering The from au attack of acute dysentery. disease ran a rapid and fatal course, and he died the third day after admission. From patient's medical history sheet, it was ascertained that he enlisted in 1886, and that he was a temperate man of good character. About a year ago he had been brought before a Medical Board to be invalided to England on account of a loose body iii his right knee-joint. As this loose body could not be felt from outside, the disability depended solely on the statement of the patient. The President of the

Brigade, Bareilly,

was on

i

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