VOL. XLIV.] PHILOSOPHICAL TRANSACTIONS. 247 



length, and more than 2 in circumference: the centre forming a tubular channel, 

 wherein the medulla of the bone had formerly been inclosed. This was an ex- 

 foliation fairly separated from the surface of all the medullary cavity of the bone, 

 but improperly called an exfoliation, as the thickness of the bone throughout was 

 as thick as a shilling : it was more substantial in some places than in others, and 

 opened here and there, so as not to be a complete tube. But what perhaps may 

 be thought to deserve more notice is, that this loose bone, though it had for 

 many years been soaking in the matter lodged in the bone (which, at times, had 

 worked its way out, by perforating the surface of the os humeri externally), yet 

 this exfoliation was in nowise altered, or tainted with cariosity, as the main bone 

 was; but in every respect so sound, as to give ground to hope the posterior part 

 of the OS humeri might be so; but it happened otherwise. > 



On the removal of this exfoliation, the whole internal surface of the bone was 

 found of a substance like a cartilage : it was bare in some places, and covered with 

 flesh in others. The flesh was fungous in the lower extremity of the bone that 

 was carious ; firmer towards its upper end, where it was sound , and callous to- 

 wards the middle, which was degenerated into a cartilaginous substance. 



The removal of this exfoliation having laid open the whole bone, in the inferior 

 part of it was found a sinus leading into the articulation with the cubit, and a 

 cariosity in the bone there ; and, in the upper end, where the bone appeared now 

 sound, but fomierly was distempered, several foramina, which were filled up with 

 flesh, under cover of the deltoid muscle. 



At this time the surface of the wound was very large, and the discharge from 

 it greater than the patient could support. His stomach hitherto had been good; 

 but that being defective, and a hectic fever with a diarrhoea attending, the am- 

 putation of the limb was concluded on. It was taken oft" near the articulation 

 with the scapula, where the bone was sound. The patient did not survive it long; 

 for the diarrhoea increasing, he died spent, within 4 days after the operation. 



The humerus next to the shoulder-joint did not, after the patient was dead, 

 appear so sound as it had during life : for the matter proceeding from the bone, 

 which was found, in 2 or 3 places of it, under the deltoid and pectoral muscles, 

 showed that this part of the bone was not in that sound state it appeared in, when 

 the amputation was made. 



Observation 1. — Nov. 5, 1739, Mr. Johnson, about 26 years of age, having 

 complained for 1 2 months past, of a swelling in the bone of his right arm, wliich 

 seemingly had been the cause of several imposthumations he had had thereabouts 

 since, then applied to Mr. A. for cure. He could assign no cause for this swell- 

 ing, saving his taking cold, as he imagines, after having exercised himself by 

 flinging heavy stones to a great distance : for that soon after he was seized with a 

 fever, and a great swelling from the neck to the finger's end of this arm ; which 



