f 355 ] 
an opening, to cut away the head of the bone. I 
determined upon the latter ; and accordingly began 
my incifion from the upper orifice, near the clavicle, 
and continued it over the joint to the infertions of 
the pedoral mufcle: but finding a fingle incifion 
too fmall, to allow me to get at the head of the 
bone readily, I feparated a part of the deltoid mufcle. 
from its infertion into the clavicle ; and likewife a 
little of its infertion into the humerus , which gave 
me liberty to come at the joint, the capfular liga- 
ment of which, from frequent inflammation, was 
fo thickened, and kept the head of the bone focloib 
to its focket, that it Was with difficulty I could in- 
troduce a fpatula between them. This likewife, 
after opening the ligament, prevented the head of 
the bone from rifing out of its focket, upon prefling 
the elbow backwards, as is common in performing 
the operation upon a dead body, when the joint is 
in a found ftate; fo that I was obliged to feparate it 
quite round, before I was able to come at the bone 
with the faw. I then moved the elbow backwards, 
and brought the head of the bone over the pe&oral 
mufcle, as I faund it impoflible to faw it dire&ly 
a-crofs, as Mr. white direds, without leaving a 
confiderable portion behind, that had been laid bare 
with the knife, and which, in all probability, mufl: 
have exfoliated. By placing a card betwixt the edge 
of the deltoid mufcle and the bone, and the faw 
within the incifion, with its point into the joint, I 
cut off all that had been deprived of the periofteum y 
and had no exfoliation j nor had I occafion to take 
up one artery. As the tendon of the biceps mufcle 
was cut through, 1 kept the fore-arm fufpended. 
Z z 2 ' My' 
