540 PHILOSOPHICAL TRANSACTIONS. [anNO 1 72 1. 



enjoyed a good state of health, sent for me on account of a mortification 

 which had begun about a month before on one of his toes, and by gradual ad- 

 vances in that time had reached half way up his leg: and this without any mani- 

 fest cause. In such a case, what was to be done? the gentleman saw himself 

 dying daily by piece-meal, but heart-whole, as he expressed it, and had a pretty 

 good pulse. I proposed amputation, as the only remedy, which he readily 

 consented to. 



The leg being taken off at the usual place, 4 inches above the mortification, 

 2 or 3 ounces of blood issued out from the muscular part ; but on slackening 

 the tourniquet, in order to look for, and tie the artery, to my great surprise, not 

 one drop of blood flowed out. On feeling the extremity of the artery, I found 

 it hard and callous; however, I secured it by a ligature, as usual, and dressed 

 the stump. The patient, who had borne the operation with the greatest reso- 

 lution, being put to bed, I was desirous to examine the leg; and having dis- 

 sected the artery, with its two considerable branches as far as the tarsus, I found 

 them for the most part ossified, that is to say, the trunk, where it was ampu- 

 tated, was ossified about two-thirds of its circumference. About a quarter of 

 an inch lower, the whole was bony, leaving so small an orifice, that it would 

 only admit of a hog's bristle. A little lower it was on one side bony, on the 

 other membranous; then again an entire case of bone. Here and there, for 

 the breadth of a barley-corn, there was no bone at all. I opened about 2 

 inches of the internal branch immediately above the malleolus, it appearing 

 blacker than the rest; after it had been washed, I found in it 2 or 3 drops of 

 coagulated blood; and now being expanded and dried, it is one entire lamina 

 of bone, as thick as the shell of a pigeon's egg, and of an unequal surface. I 

 dissected 3 ramifications of this internal branch- into the foot; only one of 

 which had a very small bit of bone in it, about half an inch from the trunk. 

 The other great branch, that runs on the ligament that ties the fociles together, 

 was not so much ossified. 



This ossification, the completest of any I have yet heard of, was doubtless 

 the cause of the mortification, and of the death of my patient, which followed 

 4 days after the amputation. 



This bony shell, or lamina, was contained within the tunicles or coats of 

 the artery. I doubt not but these cases are more common than we imagine. 

 For when we see mortifications seize the extremities of aged people, which we 

 commonly attribute to a decay of nature, or an extinction of the vital warmth; 

 this I believe is often the cause. And I am the more inclined to think so 

 from two or three parallel cases I have met in my practice. 



