ght
position was apparently complete.

The comparatively frequent association of popliteal aneurisms with
wounds of the knee-joint has already been spoken of in relation to
anchylosis. Wounds of the popliteal space from larger bullets sometimes
caused more troublesome after-stiffness than wounds of the articulation
itself. Again I remember a small pom-pom wound at the inner margin of
the ligamentum patellae without obvious wound of the joint, which was
accompanied by synovitis from contusion, and was followed by very
considerable limitation of movement. This had only been partially
improved when the patient returned home, in spite of prolonged massage
and passive movement.

The general remarks on the joints cover all that need be said as to
suppuration of the knee-joint.

_The ankle-joint_ maintained the undesirable character which it has
always held as a subject for gunshot injuries. This is entirely a
question of sepsis, and in great measure depends on the fact that the
foot, as enclosed in a boot, is invested with skin particularly
difficult to thoroughly cleanse; while the socks are an additional
source of infection to the wounds before the patients come under proper
treatment.

Of seven cases of suppurating ankle-joint, of which I have notes, only
two retained the foot, and one of these after a very dangerous illness.
This case was one of special interest as exemplifying the results
dependent on variations in velocity on the part of the bullet. The
patient was struck at a distance of twenty yards. The bullet entered the
front of the right ankle-joint and emerged through the internal
malleolus, just behind its centre, causing no comminution of the latter.
It then entered the left foot by a type wound one inch behind and below
the tip of the internal malleolus, traversed and comminuted the
astragalus, and emerged one inch below the tip of the external
malleolus. The first joint healed _per primam_. The second produced by
the bullet when passing at a lower rate of velocity was accompanied by
considerable comminution of the bone. It suppurated, and gave rise to
great anxiety both for the fate of the foot and the life of the patient.
It is probable that the more abundant haemorrhage which took place from
the second wound was in part responsible for the occurrence of
infection.

The second of the two cases is of some interest in relation to the
doctrine of chances as to the position in which a wound may be receive