panied with a hernia inteftinalis. We fhall extract the account of the fecond tumour, as being of a very extraordinary fize. It is related by Dr. White, the author's father, by whom it was fuccefsfully extirpated.

July 20, 1725, I was fent for to Mr. Warrington, of Whaley bridge, in Cheshire, a very tall, ftrong, lufty man, aged feventy-two, About twenty years before, he had perceived a hard tumour in his right tefticle, which had, fince that time, gradually increased to fuch an enormous bulk that he could not, without the greateft difficulty, either fit or walk. At last the pain, occafioned by its tending to a fuppuration, together with a fever, obliged him to keep his bed. He likewife complained very much of a pain in his loins, and a difficulty of making water, together with great coftiveness. When the bandage by which the tumour was fupported from his neck was taken off, I viewed it, and found the fcrotum to measure, from the os pubis to the bottom, near thirty inches, and apparently capable of containing five or fix gallons. The penis was entirely buried in the tumour, a small hole, not unlike a nayel, remaining for the discharge of the urine. The tumour had burst of itself in the most depending part, and the people about him had catched a gallon of reddifh matter, with a red fediment, befides what was loft in the bed, and upon the cloaths.

Upon examination with a probe, I found a large putrid body, that proved to be the right tefticle in a corrupted state, grown to the fize of a child's head, which blocked up the orifice, and hindered the difcharge of the matter. I dilated this orifice with a pair of crooked fciffars, and two gallons more of the fame matter were discharged, together with the tefticle, which I eafily took out. Its internal fubftance was of a bright red colour. After taking up an artery which had been divided, I filled the cavity with tow, well moistened with Spirit of wine and mel. Egypt, made warm, and applied the proper dreffings, He refted very ill that night, and a great quantity of thin purulent matter was discharged. His pulfe was unequal and trembling, the affected parts were cold, and this large bag, which the day before was three fingers thick in the bottom, callous, and rigid, in the morning was become quite flaccid. All thefe iymptoms ftrongly indicating a mortification, I forewarned my patient and his friends of the danger, in order that extirpation might immediately take place. This being confented to, I proceeded in the following manner: I introduced my hand and arm beyond the elbow, by the incifion that was already made, in order to find the penis, and preferve it unhurt; I then divided the fac from its

bafe

bafe to the hole where the urine was difcharged, and diffected the skin round the penis, preferving as much of it as poffible towards the os pubis, that the furface of the wound might be leffened. I finished with cutting off both fides from the groin. He bore this tedious operation with the greateft fortitude, and the whole wouud was cicatrized in two months. The penis was restored to its natural figure; and, notwithstanding his long illness, his advanced age, and the great discharge of blood and matter, he perfectly recovered a vigorous ftate of

health.

It is worthy of obfervation that the fpermatic veffels on both fides had degenerated into ligaments, and did not difcharge a drop of blood. The left tefticle was foft, flaccid, and increased, to near the fize of a horse's. It was affected with a perfect hydrocele. The whole mafs of flesh, after the operation, weighed eight pounds.

This cafe feems parallel to that of the negro, of which Mr. Chefelden has given a figure, with the following defcription in his Anatomy, edit. 4. tab. 26.

"The lower parts of a negro, whofe fcrotum was swelled to this fize, from a kick, (the spermatic veffels being not at all thickened) the greateft length was twenty-seven inches, and the greatest horizontal circumference forty-two inches. He was the late Mr. Dickenfon's patient in St. Thomas's hofpital. The tumour was folid, without inflammation or pain; but what parts were affected we could not learn, he not staying for the operation. At the dark place he could pull out the penis, when the scrotum was lifted up."

In a converfation I had fome years after with Mr. Chefelden, he was much pleafed with my relation of the above cafe, and regretted very much the negro's running away out of the hofpital, and depriving him of the opportunity of feeing the event.'

We are afterwards prefented with fome ufeful obfervations on the tumours of new-born children, together with the vari valgi, or diftorted feet.

The next cafe is an account of the fuccessful treatment of a locked jaw, and other fpafmodic symptoms, supposed to have been occafioned by a wound of a finger, and published in the Medical Obfervations. The two fuceeeding papers are republished from the Philofophical Tranfactions. One of them contains a case in which the head of the os humeri was fawn aff, a large portion of the bone afterwards exfoliated, and yet the entire motion of the limb was preserved. The other is an account of a remarkable operation on a broken arm. The fubjects of the following articles are, a fractured thigh, attended

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attended with uncommon circumftances; and an account of an operation performed upon a broken leg, in which the fractured tibia was not united, though thirty-fix weeks had elapfed after the accident. Thefe are fucceeded by an account of a new method of reducing fhoulders, which have been several months diflocated, without the ufe of an ambe, in cafes where the common methods have proved ineffectual, republifhed from the Medical Obfervations, and accompanied with a Supplement, containing more ufeful remarks on that fubject. After this, is an account of a complete luxation of the thigh bone, in an adult, by external violence, and inferted in the Philofophical Transactions. The following cafe, of a diflocation of the eye, as it is termed by the author, is fo remarkable that we shall extra& it.

C. D. applied to me about ten years ago, upon account of the following remarkable accident which had juft happened. As he fat in company, a perfon thruft the fmall end of a tobacco-pipe through the middle of his lower eyelid. It had paffed between the globe of the eye and the inferior and external circumference of the orbit, which is compofed of the os mali, and was forced through that portion of the os maxillare, which conflitutes the lower and internal part of the orbit. The pipe was broken in the wound, and the part broken off, which from the examination of the remainder appeared to be about three inches, was quite out of fight, or feeling; nor could the patient give any account of what was become of it. The eye was diflocated upwards, preffing the upper eye-lid against the fuperior part of the orbit; the pupil pointed upwards perpendicularly, the mufculus deprimens was upon the full ftretch, and the fight of the eye was intirely taken from him. I applied one thumb above and the other below the eye, and, after a few attempts to reduce it, the eye fuddenly flipped into its focket. The man inftantly recovered his perfect fight, and felt no other inconvenience than that of a conftant finell of tobacco-fmoke in his nofe for a long time after; for, as he informed me, the pipe had just been smoked in before the accident. About two years afterwards he called upon me to acquaint me, that he had that morning, in a fit of coughing, thrown out of his throat a piece of tobaccopipe, meafuring two inches, which was difcharged with fuch violence as to be thrown feven yards from the place where he ftood. In about fix weeks he threw out another piece, meafuring an inch, in the fame manner, and has never fince felt the leaft inconvenience.'

Remark.] Perhaps the term diflocation, for which indeed, in this cafe, I have no precedent, may be objected to. I be

lieve we have here an accident that was never defcribed by any author; but the eye was certainly as much dislocated as ever a joint was; and the etymology of the word will undoubtedly bear the application I have given it. I am not at all amazed that the tunica conjunctiva and the muscles should bear to be fretched, without fuffering any injury; but it is rather furprifing that the optic nerve, after being fo fuddenly elongated, should in no refpect fuffer, and that the man fhould recover the perfect fight of his eye immediately after its reduction. It was luckily indeed not above half an hour in this unfortunate fituation; had it been longer, in all probability, the event would not have been fo happy for my patient.'

There follows next an account of an extraordinary tumour on the lower part of the orbit of the eye, thrufting the eye out of its focket, fuccessfully extirpated by Dr. Thomas White.

As the diffection of a part on which the operation for an aneurism had been performed, is fo extremely rare, we doubt not but many of our medical readers will be pleased with the following information; and fhall therefore only obferve that there is a plate delineating the preparation.

About two years ago a woman died in the Lunatic Hofpital in Manchester, who, about fourteen years before, had undergone the operation for an aneurifm, occafioned by bleeding in the right arm, which perfectly fucceeded. As opportunities of examining the ftate of the parts after death feldom occur, I was determined not to mifs that which now offered. I accordingly injected the axillary artery with wax, and then took the arm off at the joint, and diffected it. annexed figure is a true reprefentation of its appearance.

The

As I do not recollect to have feen or heard of a preparation of this fort, I imagine it will not be unacceptable to the public. We may here not only admire the wonderful power of nature in continuing the circulation, when almost three inches of the principal artery were obliterated, but furgeons may be encouraged never to defpair of fuccefs in a fimilar operation for in this cafe the humeral artery was tied above its divifion into the radial, ulnar, and interofocal arteries: and the fmall capillary arteries appear to have undergone fo great a dilatation, as when taken together, to exceed in diameter the trunk of the humeral artery, which, by their tortuous anaftomofes, they fill again beneath the obliteration.

My worthy friend Dr. Hunter has done me the honour to give this preparation a place amongst his valuable collections.' All the remaining cafes relate to the ufe of the fponge in ftopping hæmorrhages; a practice recommended by this inge

nious

nious author in a former publication, and now enforced by farther experiments. Befides the advantage of the sponge in ftopping hæmorrhages, Mr. White fubfcribes warmly to its good effects in preventing the abforption of matter, as foggefted, in the Medical Obfervations, by Mr. Kirkland. We fhall extract the author's conclufion of the important fubject of these cases.

• Conclufion.] I made ufe of the sponge for the stoppage of hæmorrhages in all cafes indifcriminately, for near three years, in which time there were nineteen amputations of the larger extremities, fix of which were of the thigh, and most of the principal operations of furgery, as lithotomy, caftration, bubonecele, the trepan, fchirrous and cancerated breafts, and encyfted tumours, befides many accidental wounds, and violent hæmorrhages from the extraction of teeth, where it was peculiarly ferviceable, and after the application of leeches. In all these trials it never failed me, except in one inftance, which was after amputating the thigh of a young gentleman, who had a white fwelling in the knee, attended with conftant convulfive twitches in his leg and thigh fo great as to raise the limb every five minutes from the pillow. These twitches continued after the operation, and would never allow the fponge to adhere. After fome ineffectual trials of it, I fecured the femoral artery with the needle and ligature, and the patient went on very well for three weeks, fo as to be able to fit up many hours in a day, to read and write, and play on the flute, but about the expiration of that time he was feized with the fymptoms of a locked jaw, and died in a few days.

Notwithstanding all these cafes in its favour, there is one inconvenience attending its ufe in very large arteries, which is its uncertainty for a very few hours after its application, fo that I never durft trust it without its being narrowly watched for fome time; but after four or five hours were expired, I always thought it perfectly fecure, even more fo than the needle and ligature.

6

Upon hearing of Mr. Bromfield's fuccefs in drawing out arteries with the tenaculum, and including the veffel alone in the ligature, I was induced to try this practice. In the large arteries which are furrounded with a good deal of cellular fubftance, the veffel may easily be drawn out alone; and here too much cannot be faid in favour of this method, which is totally free from pain, and from the inconvenience attending every other mode of practice. But the fmall arteries fituated amongst the muscles can seldom or ever be drawn out without fome of the fibres of the mufcles with them, the tying of which muft neceffarily be attended with pain. Yet here Ţ