. Un traité pratique sur les fractures et les dislocations . dix-sept cas de séparations de cette sym-physe survenant en couches, dont seulement sept ont survécu. Il est beaucoup plus fréquent, cependant, de trouver les pubes brisées par son ramus horizontal ou ascendant; et Clark, de l'hôpital général de MassachussettsGeneral, a décrit un cas de fracture simultanée de thépubes et d'ischium en trois endroits. L'homme, set. 29, avait été caughtentre deux brassières lourdes, et le lendemain, le 7 mai 1852, il a été amené à l'hôpital. Aucun crépito n'a pu être détecté, mais il n'a pas pu se trouver du côté de la lumière du jour

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. A practical treatise on fractures and dislocations . seventeen cases of separations of this sym-physis occurring in childbirth, of which only seven survived. It is much more common, however, to find the pubes broken throughits horizontal or ascending ramus; and Clark, of the MassachusettsGeneral Hospital, has described a case of simultaneous fracture of thepubes and ischium in three places. The man, set. 29, had been caughtbetween two heavy timbers, and on the following day, May 7, 1852, he was brought to the hospital. No crepitus could be detected, but he was unable to lie upon theright side, and the right limb was nearly paralyzed. It was evidentthat the bladder or urethra had been ruptured, and on the third dayDr. Clark opened the bladder through the perineum, evacuating alarge amount of blood and urine, and affording to the patient verysensible relief, on the first of June, however, he died, having sur-vived the accident twenty five days. 1 Sir Astley Cooper, Frac. and Disloc, Amer. ed., p. 144. 334 FEACTUEES OF THE PELVIS. Fig. 99.. Clarks case of fracture of the pelvis. The autopsy disclosed several fractures, all of which belonged tothe right os innominatum. First, a fracture of the pubes, near the symphysis; second, a fracture nearthe junction of the pubes and ilium;third, a fracture through the ramusof the ischium anterior to the tubero-sity.1 Sir Astley mentions a case (Case83) of fracture of the ramus of thepubes, unaccompanied with injuryto the bladder or urethra, which re-sulted in a complete recovery; andin another case (Case 84) the patientrecovered in eight weeks, and wasable to walk nearly as well as before:but he soon after died of diseaseof the chest. The os pubis wasfound, at the autopsy, to have beenbroken in three places; there wasalso a fracture extending in twodirections through the acetabulum, with an extensive comminuted frac-ture of the ilium accompanied with great displacement. Maret has even found it necessary after a fracture to remove

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