24 ON A NEW METHOD OF TREATING 



have been known. That there is a reasonable ground for this behef will, I trust, 

 appear from the discussion in the succeeding section. 



For a long time the progress of the patient continued satisfactory, the 

 process of union of the fragments advancing steadily, till in the early part of 

 February, the bone being firm, the splints were entirely discarded, and the case 

 was reduced from one of fracture to one of limited exfoliation. It was satis- 

 factory also to find that the knee-joint continued movable, so that I confidently 

 anticipated recovery, with a perfectly useful limb. 



At this period, however, a new symptom presented itself — viz. haemorrhage 

 from the sinus. Mr. Hector Cameron, my present house surgeon, who saw the 

 first appearance of bleeding, supposed it to proceed from the surface of the 

 granulations ; for it was then small in amount, and ceased spontaneously. 

 Some days later, however — viz. on the nth of February — a very profuse haemor- 

 rhage occurred, the blood soaking through the bed, and dropping upon the floor 

 beneath, before it was observed, and the gentleman who was summoned to see 

 the patient in Mr. Cameron's absence, found him pulseless. He afterwards 

 rallied to some extent, but remained utterly prostrated, and unable to retain 

 the slightest nourishment. As the popliteal artery could be felt beating in the 

 lower part of the ham, I hoped that the source of the blood might be some 

 minor branch, which might possibly close. But it afterwards appeared that 

 a circular opening existed in the main vessel, occasioned no doubt by the pres- 

 sure of an irregular projection of the lower fragment. It would be irrelevant 

 to relate particularly the history of his yet further exhaustion by recurrent 

 haemorrhages after delusive temporary cessations, or of my attempts to restore 

 him by tying the popliteal artery, and making arrangements for transfusion, to 

 which he declined to submit. He died on the 25th of February. 



The next four cases occurred in the practice of my colleagues in the infirmary, 

 who have kindly placed them at my disposal. 



Case 7. — Mary M , aged sixty-two, was admitted under the care of 



Dr. Morton on the 13th of August, 1866, at eleven p.m., when she stated that 

 about five o'clock in the afternoon of that day she missed her footing when going 

 downstairs, and fell with violence, and on getting up found that her right fore- 

 arm was broken and bleeding. A medical man was called in, who made various 

 applications in order to stop the haemorrhage, but failed to do so, and she 

 was advised to go to the infirmary. Mr. A. T. Thomson, the house surgeon (to 

 whom I am indebted for notes of the case), on removing the bandage, from 

 which blood was trickling, found both bones of the forearm broken a little 

 above the wrist, and a detached fragment of the radius projecting from a 



