(52) nisroRT of the sociE-rr. 



Account of mentioned, who followed his profeffion for upwards of five and 



twenty years before his death, and who, by being obliged to 

 life his arm, acquired tlie motion of the new joint fooner than 

 if he had been under no fuch neceffity. 



" It is a matter of importance to afcertain when the changes, 

 w«i have defcribed, take place. I imagine the recent ftate may 

 continue for a fortnight or three weeks : But ftill we want ob- 

 fervations to point out when the mufcles become completely 

 adapted to the nevr fituation of the bones ; when the glenoid ca- 

 vity begins to lofe its ihape, and the ligament to adhere to it ; 

 and, particularly, when the furface of the fcapula begins to be- 

 come hollowed and fmooth, fo as to receive the head of the hu- 

 merus. Thefe, however, may be gueifed at, by the quality and 

 degree of motion enjoyed in the diflocated joint. Were thefe 

 points fully afcertained, they would guide us in our practice, 

 and prevent attempts being made to reduce old diflocations, 

 where the furgeon, from want of knowledge of the procefs car- 

 rying on by nature to form a new joint, and the obliteration of 

 the old cavity, racks the patient's limbs to no purpofe ; and even 

 fliould he be fuccefsful, he might be faid not to reduce, but 

 really to diilocate, as he deflroys a new joint beginning to en- 

 joy motion^ and throws the end of the bone on a furface which 

 has now loft every thing necelfary to make it a part of a joint." 



Mr Hamilton had cccafion once to open the cheft of a 

 Lacly^ wdio had water in her breaft. The quantity at firft 

 drawn off amounted to fixteen ounces ; a great deal oozed out 

 afterwards, and fome of the fymptions were for a little relieved, 

 but the patient died in a few weeks. On the beft manner of 

 performing this operation, he makes the following remarks : 



" In Mr Bell's mode of operating, which I here followed, 

 limply drawing off the water, and avoiding every thing that may 

 bring on inflammation on the cavity, is not fufhciently kept in 

 view. An extraneous body, a canula, is introduced and kept in 



for 



