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Homais reads an article about a new treatment for clubfeet and, "being an apostle of progress and a local patriot," he wants Charles to try out this treatment on Hippolyte, a servant at Madame Lefrançois' inn. Emma and Homais both encourage Charles to experiment on Hippolyte, and he agrees to allow Charles to operate on his left foot. Flaubert compares the state of Charles' nerves to that of other surgeons attempting a new operation for the first time. After the operation, Charles returns home to a fawning Emma. They chatter pleasantly and dream of a prosperous future. Homais writes about the 'event' in his article for the Beacon.
Five days later, Hippolyte's health takes a bad turn, and the foot appears gangrenous. Three days later, a "livid tumor" begins to spread up the leg, and Hippolyte loses hope of recovery. Charles does nothing to treat the infection. The Abbé Bournisien visits Hippolyte and attempts to effect a cure through religion. Madame Lefrançois asks for Charles' consent to send for the well-known Doctor Canivet of Neufchâtel, who and declares that he will have to amputate the gangrenous leg at the thigh. Homais does not reveal to Canivet that he has been part of the 'clubfoot operation' and tactfully humors Canivet while assisting in the amputation.
During this time, Charles does not leave home. He bemoans his fate and fears the possible controversy that will probably erupt as a result of his actions. Emma is clearly devastated and wonders how she could have pinned her hopes on Charles. When her husband expects Emma to comfort him, she flies into a rage; the naive Charles interprets Emma's strange mood as excessive concern for his personal grief. Emma, feeling "irrevocably estranged" from Charles, is drawn to Rodolphe with a "new enthusiasm." That night, Rodolphe and Emma are together again.
This is the first time in the novel that Charles exhibits any real excitement about his professional life. With the club foot operation, he may finally improve his reputation as a doctor, which is what Emma has wanted all along. Emma is pleased to see some ambition in her husband and is glad that she has chosen to try and love Charles again. She dreams of the operation bringing them fame.
Flaubert describes the clubfoot in great detail. He also negatively compares Charles' emotional state at the time of the operation with that of other doctors preparing for surgery. He also pokes fun at Homais' pompous article about the success of the operation and the priest's attempt at a religious cure for Hippolyte.
The unsuccessful outcome of the operation has several results. Charles is driven into a fit of despair. Homais, never know for loyalty, quickly extricates himself from Charles and the whole this mess and tries to ingratiate himself to Canivet, the new doctor called in for treatment. The Emma-Charles relationship alters again. She is livid at his failure and rejects him as a loser. She realizes that "everything about him grated on her now, his face, his clothes, the things he didn't say, his whole person, his very existence. She repented her past virtue as though it were a crime; what still remained of it collapsed beneath the savage onslaught of her pride." Emma returns to Rodolphe with a passion, acting as if Charles were alien to her.