VOL. XLIV.] PHILOSOPftlCAL TRANSACTIONS. 249 



found to have destroyed above 4 inches of its body ; and also for the removal of 

 the fragments and loose bones confined in the medullary cavity, and the applica- 

 tion of the necessary means, as well to stop the progress of the evil, as to pro- 

 mote the casting off of the morbid bones. 



But the work was far from being finished, as, on the extracting the foremen- 

 tioned loose bones, it appeared that they had a fungus sprouting, as well from the 

 circumference of the medullary cavity above and below that part of the bone 

 which had been operated on, as from the callous expansion over its outward sur- 

 face, occasioning a greater discharge of sanies than the patient's strength could 

 support ; that the opening in that cavity was not yet sufficient to discharge all 

 the matter deposited in it, as well through a fistular opening in the internal part 

 of the bone answering to the axilla, as another somewhat lower over the large 

 vessels that run on the surface of the bone internally, that, being sheltered above 

 and below, they could not come at them without enlarging further the opening 

 in the bone externally. This laid them under the necessity of enlarging this 

 opening in its upper and lower part, so as to bring in view the forementioned. 

 These were enlarged with a terebellum, without any hazard of wounding the large 

 blood-vessels, which were sheltered by the callous expansion lining the carious 

 bone on this side : and having thus rendered easy the discharge from all these 

 cavities, they had nothing to struggle with then but the running; which from 

 this time became daily less ; that from the internal part of the arm, by the matter 

 having a more easy vent for itself; and that from the fungus on the bone by a 

 solution of the lapis infernalis it was dressed with. Mr. Singleton, surgeon in 

 Aldersgate-street, being consulted on the case, on the 1 8th day from the first 

 operation, was of opinion, that the amputation was hardly practicable ; the sinus 

 into the medullary cavity showing that the cariosity was up to the head of 

 the bone; but that, if it was practicable, he thought the patient had afar better 

 chance for his life, by pursuing the cure in the way he was in. At this time they 

 had but in part subdued the fungus that was continually sprouting up from the 

 sinuous vacuity in the upper part of the bone, where the medulla was all wasted 

 as well as from that which was yet growing without the bone from the callous ex- 

 pansion by which the carious bone was covered : but this was so effectually over- 

 come and conquered by the repeated application of the actual cautery, and by it 

 the bone so dried up, that in less than 1 months from its use all the morbid bone 

 had cast off'. 



The quantity of the morbid and carious bone taken out at divers times, being 

 about 4 inches of the solid, was effectually repaired, by the matter flowing as 

 well from the circumference of the callous expansion about it, which all along had 

 steadied the patient's arm so, that he could pull his stockings on and off", as from 

 the matter flowing from the ends of the os humeri into the aivity formed romid 



VOL. IX. K K. 



