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my imoft grateful acknowledgments. But, on the other hand, if you mean that any thing you could fay, although ever fo fhort, would not be interefting enough for the Review---In proof of the contrary, I refer you to the infertion of your paft letters.

Any matter that is foreign to our difpute, as far as it relates to the propriety of my criticifm, I have every right to deem impertinent. How then fhall I confider your mention of Mr. Toplady and Dr. Priestly on Neceffity? What reference has that to our dif pute on Free-Agency---which, as it relates to myself, I have called upon you to answer my obfervations in its favour? It is not referring me to Libraries, nor noticing the Review having maintained the doctrine of neceffity, that can excufe your perfonal anfwers to what I have, fince you began the attack, all imaginable reason to demand; and to call upon you neither to defert the lifts you forced, nor to oppofe the fades of the dead to bear the brunt of that oppofition you yourfelf have provoked.

If you intend to lead me into the Revelations, all our dispute muft immediately be finished. It would indeed be impious to argue against what the divinity is fuppofed to dictate. So that, if we are to continue this any further, I beg you will neither mention Revelations, nor any perfons fo nearly related to them as are archbishops. They thould be too facred to be bandied about in a literary altercation. All I have to request is, in few words, to give plain, rational, uninfpired refolves to my very few questions. This will confirm me in an opinion of your being a fenfible man---a far more eftimable character than a felf-infpired, fanatical faint,

I

Sir,

am,

With all due refpect,

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Your moft obedient Servant,

W.

Arfwers to Correfpondents.

Our Correfpondents, who in obliging us with literary information, or other marks of their approbation and efteem, expect a return of civility by private letter, are begged to excufe our noncompliance with fo feemingly reafonable an expectation; as the multiplicity of their epiftolary favours, and the objects of our attention, are fo great, as to put it abfolutely out of our power to make fuch particular returns of our gratitude and esteem.

We are forry we cannot comply with the request of " Sophia M-; but the London Reviewers make it an invariable rule, not to give any opinion about unprinted productions. Our fair correfpondent is therefore defired to fend for her manufcript, which is left with our publisher under cover, directed to Sophia M-."

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We are obliged, much against our inclinations, to poftpone our review of foreign books till next month, when we hope to refume that branch of criticifm.

THE

LONDON REVIEW,

FOR APRIL 1780.

Philofophical Tranfactions of the Royal Society of London. Vol. lxix. for the Year 1779. Part I. L. Davis. [Continued from page 78.]

We have already given à very copious account of a petrification found in Scotland, with feveral remarks on the making artificial ftone-an art which we truft will foon be brought to great perfection.-We fhall now, for the benefit of our medical readers, extract a very extraordinary cafe where the head of the Os Humeri was fawn off without deftroying the motion of the limb.

We have great hopes that this operation will lead to confiderable improvements in furgery, and be the happy means of rendering amputations less frequent.

"A cafe in which the head of the Os Humeti was fawn off, and yet the motion of the limb preferved. By Mr. Daniel Orred, of Chester, furgeon. Communicated by Thomas Percival, M. D. F. R. S. and A. S. and Member of the Royal Society of Phyfi cians at Paris.

"Read Oct. 12, 1778. "SIR,

Manchester, Sept. 20, 1775

"A very eminent furgeon at Chefter has defired me to transmit the inclofed cafe to the Royal Society, and I hope it will be deemed worthy of publication. It not only affords a confirmation of an important fact inferted in the Philofophical Transactions, vol. LIX. art vi.; but fhews alfo that the chirurgical improvement propofed in that article by my ingenious friend Mr. Charles White, may be extended to operations on other parts of the human body. I am, THO. PERCIVAL. "A friend of mine, an ingenious furgeon, fettled at Tarpor ley, in this county, fent for me about the middle of last month to fee a patient of his, a gentleman's fervant in that neighbourVOL. IX. Ff

&c.

hood

hood. This was a man of about forty years of age, who had much injured a good conftitution by hard drinking before the following accident happened to him.

"From an injury received more than three years before the time I faw him, by a fall from the top of a ladder, I found a fuppuration had taken place in the shoulder joint. The matter had made its way through three fmall openings; one in the axilla, di'rectly oppofite to the cavity of the joint; the other two lower than the ftrong tendons of the pectoral muscle, and betwixt the deltoides and biceps muscles. Upon introducing a probe into the joint by the upper orifice, I found the head of the os humeri exceedingly carious. A few weeks before I faw him, a collection of matter had formed upon his foot, I fuppofe from an abforption and tranflation from the fhoulder. Upon letting out the matter with a lancet, I found the metatarfal bones alfo very carious: with these fhocking complaints no wonder he was much enfeebled and reduced. As the difeafe in his fhoulder would evidently foon have put a period to his life without immediate relief, I propofed to him, either to amputate the arm at the difeafed joint, or, with a view of making it of fome ufe to him, endeavour to faw off the head of the affected bone only. As the least of two evils he chose the last; though this indeed is a most painful, hazardous operation. We are indebted to Mr. White, of Manchester, for the mode of this operation, as well as for many other valuable hints and difcoveries in furgery. In order to allow the arm as much action as poffible after the operation, I began my incifion a little above the joint, and continued it in a right line directly through the middle of the fleshy portions of the deltoides, and a little lower than its infertion: then elevating the arm to relax the muscle, an affistant with both hands diftened the upper part of the opening made by the incifion, whilft, with a narrow knife, I endeavoured, by the direction of the fore-finger of the left hand, carefully to divide the capfular ligament. This was effected with very great difficulty, as from preceding inflammation it was much thickened, and adhered clofely to the joint: and till it was feparated nearly round (for the under, and moft dangerous part to cut through, was corroded with matter) I found my utmoft efforts to throw the head of the bone out of its focket quite ineffectual. After a fufficient feparation I made the diflocation, by preffing the elbow to the body with one hand, and with the other pulling the head of the humerus directly towards me. After guarding the great artery against the action of the faw, by introducing a piece of pasteboard under the bone, I feparated it acrofs, as Mr. White directs, as low down as I poffibly could to prevent an exfoliation. The lofs of blood was very trifling. After dreffing the wound very fuperficially, I took particular care that the artery was not preffed upon by, the bandages; and advised, when the inflammation fubfided, and a good digeftion came on, that his arm fhould always be dreffed when the body was erect, and fufpended a little from it, with the fore arm a little bent: this was accordingly done. In a

few

ew days after the operation, he got up, and continued to fit up he day through ever after. He had a cold infufion of the Peruvian bark with the weak spirit of vitriol ordered him. In confequence of his very reduced habit of body, his fhoulder was long in curing. A fmall exfoliation took place. The cure, I fancy, was alfo much retarded by the difeafed foot, which ftill continued very bad: the man being fo exceedingly terrified by the former operation, that he would not suffer us to do any thing to any purpofe to it.

"I saw him about three months after the accident. The wound was nearly cicatrized; but the offification was not fo far advanced as I expected it would have been, the callus being much finaller than the lower part of the humerus, and bending with the weight of the arm. However, he could raise it from his body more than could be well fuppofed, and had the perfect flexure and ufe of his fore arm. This cafe, with all the difagreeable circumstances attending it, ftrongly proves the utility of the above operation. By a fimilar operation difeafes of other joints may be as eafily cured."

The following is a remarkable dropfical cafe :

Account of an extraordinary Dropfical Cafe. By Mr. John Latham, in a Letter to Mr. Warner, F. R. S. "To Mr. Warner.

Read Dec. 17, 1778.

"SIR,

Dartford, Oct. 28, 1778. "When I last had the pleasure of feeing you, it was your opinion, that the Royal Society would receive fome fatisfaction in my giving fome account of the cafe of Mifs A. M. who died lately of a dropfy under my care.

"This patient was of a florid, lively conftitution, but from a child was fubject to a violent eruption, which came generally on a fudden, covering the whole neck, breaft, and often great part of the face; and after remaining a week or two, abated in violence, and went off by degrees. The intervals were uncertain, but for the most part in fpring and in autumn fhe was more apt to have it, though frequently three or four times in the year. Various methods were tried to eradicate this complaint without effect; nor did the appearance of the menfes, as we had fome reason to hope, in the leaft turn out in her favour. It will be needlefs to relate here the various medicines which had been given her with little or no fuccefs, except that the most relief the found was from the use of falt water, which was thought to make the intervals the longer in two or three inftances, as well as the appearance of the eruption milder. Things continued thus till the autumn 1773, when the menfes became obftructed, continuing fo for fome months, but appeared once more very plentifully; after which they never returned, neither did the eruption, except in the most trifling manner, About Christmas 1773, fhe complained of a weight in Ff2

the

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the abdomen, and fulness of the ftomach; which symptoms were relieved by fome gentle opening medicines. She then went on a vifit to fome friends at a distance, after which I faw her no more for two months. I learned, that during that time the complaints had returned more violent, for which the confulted a phyfician on the fpot, but without the relief fhe found at firft; for the abdomen began to increase in fize every day, and became painful, the urine high-coloured, and in fmall quantity, with thirst, and every other fymptom of an approaching dropfy.

In a narrative of this kind it may be expected, that a detail of the medicines fhe took during her illness might be noted; but as I chiefly acted in my furgical capacity, and as fhe was after this time, till the first operation, for the most part in London, under the care of phyficians of the firft eminence, it is out of my power to give fuch an account; fuffice it then to fay, that she was obliged to fubmit to the operation of the paracentefis the 27th of June, 1774. The quantity I then took off was only twelve pints, fomewhat foetid, but not very dark coloured, nor was it ever after the leaft offenfive. The operation was repeated in fix weeks, when twenty-nine pints were taken off; after that time once in four weeks to the end of the year. During the whole of the year 1775 I tapped her once in a fortnight more or lefs; and in the year 1776 the for the most part underwent the operation every eight or nine days, the intervals gradually fhortening, till by the end of the year the could go no longer than a week between, which continued to the day of her death, which happened May 14, 1778, being then not quite twenty-three years of age. About a week before that time, the was troubled with inceffant vomitings, which nothing would relieve; but was better a few hours before her death, and went off pretty eafy,

"I have good reafon to fuppofe the complaint originated from a difeafe of the left ovary, for after the first tapping I felt a fubftance of the fize of a cricket ball; and, as the operations went on, this became more and more manifeft, increafing fo much as at laft to occupy the whole space of the abdomen forward, being of a very irregular form, and I am clear of many pounds weight, for fhe appeared, even after the water had been drawn off, as large as a woman in the last month of pregnancy. It would have added greatly to my fatisfaction to have been able to clear up this point in every particular, by opening her after death; but I had the extreme mortification of being denied this neceffary circumstance, notwithstanding my most earnest folicitations,

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I must, therefore, content myself with giving this bare recital of facts as above, which will ferve to record to futurity, a cafe which I believe has not its equal in regard to the number of operations. What is remarkable here is, that this young lady had a good appetite for the most part, and was very chearful; and, except a day before and after each operation, fed to vifit her friends at feveral miles diftance as he would have done in health,

and

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