e 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.

The _treatment_ consists in preventing the patient making the
particular movements which tend to produce the dislocation. These are
chiefly movements of hyper-abduction and overhead movements; we have
found an apparatus consisting of a belt applied around the thorax, and
fixed to another around the upper arm by a band which passes above the
axillary fold of the dress, useful in restraining these movements. If
these measures fail, it may be advisable to have recourse to
operation; this may consist in tightening up the capsule, the results
of which are said to be uncertain, or in detaching a portion of the
deltoid or subscapularis muscle and stitching it beneath the joint to
cover and strengthen the weakened portion of the capsule. It is
suggestive that in