CASE 975.—Fracture at the ankle joint.—Captain T. M. Howrigan, Co. H, 1st Michigan Cavalry, aged 37 years, suffered a fracture at the left ankle joint while passing through Washington, November 11, 1862. The accident was occasioned by his horse becoming frightened and falling with him, causing his left foot to be caught under the horse and to be fractured. He was discharged for disability June 30, 1863, but re-entered his regiment as Major several months afterwards, and remained in service until ultimately mustered out June 19, 1865, since which date he has become a pensioner. Examining Surgeon J. A. Brown, of Detroit, Michigan, August 11, 1869, certified to the fracture and to the tibia being partially dislocated at the ankle, and added that "motion and strength of the foot and ankle are considerably impaired." The Kansas City Examining Board reported, September 4, 1873: "Upon careful examination we find fracture of the tibia and fibula and dislocation of the internal malleolus, it being projected inward and downward, with tumefaction and pain. Close to the femur and femoral vessels at the upper third of the thigh there is found an osseous deposit about six and a half or seven inches long, one and a half inches wide above and tapering off in a wedge-shape below, and one-half inch thick, and just above this there is a smaller deposit, being two inches long and one inch wide. These deposits interfere materially with the circulation and mobility of the limb, which is atrophied and partially paralyzed. General health bad." The same board on September 8, 1877, reported the existence of " large varicose veins of the entire limb. He is feeble, very nervous, and quite lame, being compelled to support himself by a cane in walking. He is much more feeble now than two years ago, and unable to do manual labor." One year later the board reported that the pensioner "is now confined to his bed and has not been able to walk for several months. He has to have constant attendance and is not able to help himself." The pensioner died May 2, 1879. His attending physician, Dr. A. B. Sloan, of Kansas City, testified that death was caused by "exhaustion induced by ossification of the arteries in the lower limbs and the deposit of bony masses in his left thigh, resulting from the injury and exposure in the army."