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148 CASES ILLUSTRATING THE TREATMENT.
He could only with the tip of his thumb touch the protruded
chin, or the forehead when the head was bent forwards. Could
with difficulty pass the hand behind his back, and he was unable
to move it higher than the lumbar region.
Wlien the arm was passively extended, the tendon of the
biceps muscle was felt to be very tense.
Swelling was still present, especially over the outer side of the
elbow, and extended for some inches up and down, obscuring the
contours. It pitted deeply on pressure, and remained so for
some time.
Pain was felt on pressure over the swelling at the seat of
fracture ; at the elbow and wrist-joints on moving ; and in the
ulnar nerve, where it passes behind the internal condyle of the
humerus, because round it exudation had settled and filled up
the groove.
Treatment and Progress.—I took the case in hand on the 18th
of February. The treatment consisted in petrissage, effleurage,
and other passive and active movements, some with, some without,
resistance. I gave them all from the very first day. During
the treatment, crackings were often heard from the tearing of
organised exudations.
March 9th. The arm had regained its strength ; the bending
and stretching had so much improved that the angle formed
during movement was 160°. Supination and pronation were
already normal on the 6 th ; the patient could go through the
fencing movements with the sword very well. No pain in the
ulnar nerve on strong flexion ; no movements caused pain, they
were all performed with freedom and ease.
March 16th. The bending at the elbow was nearly normal;
same with the stretching. Passing his hand behind his neck,
the patient could touch between the shoulders with the fingers
and passing it behind the back, he could reach the shoulder of
the same side (i.e. the right one).
The patient had already, on the 9 th, left the hospital to
resume his naval duties. After the 16th he remained away
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