g piece across a ditch, was accidentally shot. The contents of
the gun were discharged through the leg above the ankle, carrying away
five-sixths of the structure--at the time of the explosion the muzzle
of the gun was only two feet away from his leg. The portions removed
were more than one inch of the tibia and fibula (irregular fractures of
the ends above and below), a corresponding portion of the posterior
tibial muscle, and the long flexors of the great and small toes, as
well as the tissue interposed between them and the Achilles tendon. The
anterior tibial artery was fortunately uninjured. The remaining
portions consisted of a strip of skin two inches in breadth in front of
the wound, the muscles which it covered back of the wound, the Achilles
tendon, and another piece of skin, barely enough to cover the tendon.
The wound was treated by a bran-dressing, and the limb was saved with a
shortening of but 1 1/2 inches.

There are several anomalous injuries which deserve mention. Markoe
observed a patient of seventy-two, who ruptured both the quadriceps
tendons of each patella by slipping on a piece of ice, one tendon first
giving way, and followed almost immediately by the other. There was the
usual depression immediately above the upper margin of the patella, and
the other distinctive signs of the accident. In three months both
tendons had united to such an extent that the patient was able to walk
slowly. Gibney records a case in which the issue was not so successful,
his patient being a man who, in a fall ten years previously, had
ruptured the right quadriceps tendon, and four years later had suffered
the same accident on the opposite side. As a result of his injuries, at
the time Gibney saw him, he had completely lost all power of extending
the knee-joint. Partridge mentions an instance, in a strong and healthy
man, of rupture of the tendon of the left triceps cubiti, caused by a
fall on the pavement. There are numerous cases in which the tendo
Achillis has recovered after rupture,--in fact, it is unhesitatingly
severed when necessity demands it, sufficient union always being
anticipated. None of these cases of rupture of the tendon are unique,
parallel instances existing in medical literature in abundance.

Marshall had under his observation a case in which the femoral artery
was ruptured by a cart wheel passing over the thigh, and death ensued
although there were scarcely any external signs of contusion and
po