084 PHILOSOPHICAL TKANSACTIONS. [aNNO I78O. 



XIX. On an Ossification of the Thoracic Duel. By Richard Browne Cheston 

 Surgeon to the Infirmary at Gloucester, p. 323. 



James Jones, 21 years of age, was admitted into the Gloucester Infirmary, 

 June the 5th, 1779, for very troublesome pains in his back, and hip, which, 

 from every circumstance of his description, were supposed rheumatic. On a 

 particular examination a few days afterwards, the right hip was observed to be 

 fuller than it should be ; but the thigh seemed very little altered from its natural 

 state. A blister was applied over the joint, and the usual anti-rheumatic reme- 

 dies were prescribed by the physician under whose care he was admitted. In 

 about a fortnight he complained of a violent pain in his knee, for which another 

 blister was ordered to the head of the fibula. During this time he could move 

 about the ward by the assistance of a stick, but soon after not without crutches. 



His thigh now increased in bulk, and became cedematous ; for which reason 

 another blister was applied about the middle of it, and his knee getting into a 

 contracted state, a volatile liniment was rubbed on that part. As he now could 

 not move about, even with the assistance of crutches, he took to his bed altoge- 

 ther. From this time the enlargement of his thigh advanced very fast, and his 

 knee became contracted in proportion ; so that the thigh had got into the same 

 kind of relaxed position the limb is frequently placed in when the bone is frac- 

 tured. Soon afterwards he began to find some difficulty in the discharge of his 

 urine, which by degrees increased so much, that the medicines prescribed for his 

 relief in this particular, not having the desired effect, and his belly appearing to 

 be distended from this cause, a catheter was attempted to be introduced, but it 

 could not be made to pass the neck of the bladder : a bougie however entered the 

 bladder with ease, and some water came off on withdrawing it. 



From this period, by means of very great exertions of the abdominal muscles, 

 and by occasional pressure externally, he used to discharge his urine ; but it came 

 away in small quantities only at a time, and seemed to empty the bladder but 

 very little ; for a tumour, which for many days had been perceptible on the left 

 side, and which evidently contained a fluid, afforded the usual feel of a distended 

 bladder. He now suffered very violent pains all over the abdomen, but particu- 

 larly about the region of the pubes, so that he could not bear the pressure usually 

 made for some time past to force off his urine ; and, as the catheter could not 

 enter the bladder, and the introduction of the bougie was of very little service, 

 his urine now began to dribble away involuntarily. His fever, at intervals, was 

 very considerable, his strength failed him very fast, and he received no benefit 

 from any medicines but opiates. In this most deplorable condition he languished 

 till the beginning of October, when the violence of his pains began to remit, 

 and he gradually drooped into a state of insensibility till the 10th of October, 

 when he died. 



