the opening of the artery, became dry and hard; after which the patient continued the ufe of the bandage for feveral years →→ but these are very uncommon cafes. In the prefent cafe, as the blood is ftopped, you must contrive to make a fufficient compreffion on the thrombus, with a bolfter, kept on by a steel machine, made fo as to give more or lefs preffure according as it shall be found neceffary; for if the bolfter was kept on by a roller, it would be a kind of ligature, which by obftructing the courfe of the blood in its return to the heart, would ftill increase the fwelling of the lower arm. As to other applications, fimple dreffings are fufficient.

Second Confultation on the Progress of the Difeafe.

The wound fuppurated; but notwithstanding the compreffion I made, and continued on the thrombus, on the fourth day there happened a fecond hemorrhage, which fortunately I stopped with dry lint. The fwelling of the lower arm has fince gradually increased, and now extends above the elbow.

The fever, which was flight, is now become more violent, and the patient feels a great numbness all over the lower arm. The thrombus continues in the fame ftate. What ought I to do?

Anfwer.

The return of the hemorrhage is a certain proof that there is a confiderable artery opened in the bend of the arm; and the thrombus being at the divifion of the brachial artery,, it is there we must look for the opening, without which the hæmorrhage will frequently return, and the patient die. It will be neceffary. therefore, without delay, to perform the operation for the aneurifm; that is to find out the opening in the artery, and make a ligature above and below it. The external wound where the fword entered, will then be no more than a fimple wound, and must be dreffed accordingly.

The fwelling of the lower arm, is owing either to the plugging up of the wound to ftop the bleeding, or else the compreffion made on the thrombus, and in all probability will go off after the operation, which I think abfolutely neceffary.

Bleeding, fomentations, or emollient cataplafms frequently repeated, and proper diet, will all contribute to remove it, and to all appearance the fever will abate when the dreffings become eafier. The difcharge from the two wounds will be bloody a long while, on account of the coagulated blood which remains in the interftices of the mufcles; when that ceafes, the wound will foon heal.

A crooked Knee.

A child two years old, who has no appearance of the zickets, nor what is called large joints, has the left knee bent inwardly,

inwardly, in fuch manner that when the leg is extended, it makes an angle of seventy degrees with the thigh. This occafions his turning his foot and thigh outwards when he walks. From whence proceeds this deformity? And is it to be remedied?

Anfwer.

There is no wonder that one of the legs of many children fhould be warped at the knee, or that even the bone itself should be crooked, from the fault of the nurfes, almost always carrying them on the fame arm, that they may have the freer use of that which they commonly make use of in their bufinefs. The bones of these children, being as yet soft, they easily take the turn they are given, and the joints affume it the eafier, because the capfulas and ligaments that furround them, are then but feeble. And when the joints begin to bend, the weight of the body increases the bad shape of the joint daily as the child walks.

As this diforder is contracted by degrees, fo it can only be imperceptibly removed, and it will likewife require more or lefs

time.

6 For this purpose, we must take advantage of the child's fleeping in the night, and before he goes to fleep roll his legs and thighs together, (fo that he cannot move them) without too much confining them. Children fleep foundly, and this will not disturb them. The rollers fhould be of the fame breadth and length, as thofe the nurfes ufe to fwathe them with. They are to fecure, in the places hereafter mentioned, three fmall fquare cufhions, about the fize of thofe on ladies toilets, filled with bran, moderately hard, fo as not to hurt the epiphyfes on the fides of the joints on which they are placed.

The first cushion fhould be placed between the knees, and the second between the ancles, both fecured by three or four turns of the roller. It is plain that the legs being alfo rolled, the cushion which is between the knees, by degrees will turn out the knee which is bent inwards; but as the cufhion will act equally on the other knee, and give that a wrong turn, by pushing it outwards, this inconveniency must be prevented, by placing on the outfide of the knee the third cufhion, which hould be fixed by feveral turns of the fame roller. This third cushion supporting the knee, will prevent its being turned outwards by the cufhion between the knees. I fuppofe the two legs to be extended; and to hinder the child from bending the knee, which would difplace the cushions, it will be neceffary to place a pafte-board over the knees, large enough to reach half way up the thighs and legs, and to fecure it, by the laft turn of

the roller.

The whole bandage must be merely retentive, to keep the three cushions in their place, and not to make the child uneafy.

The child muft walk but little in the day, for the weight of the body on the legs will make him lofe what advantage he has gained in the night.

6

By thefe means I have known, in about a year's time, many children, who were in the abovementioned fituation, recover. It is almost always the left leg, becaufe the nurfes generally carry the child in their left arm, that they may have their right at liberty.'

Hyfteric convulfive Fits.

A woman twenty-two years of age, lately become the widow of an old bufband, with whom he had not lived above eighteen months, is troubled with hyfteric fits, that feize her pretty frequently, according as her fpirits are exalted or depreffed. In thefe fits fhe is deprived of her fenfe and knowledge, without her pulfe feeming to be weaker; on the contrary, it feems ftronger than ordinary, without any intermiffion, and in thefe convulfions fhe talks at random, without knowing what fhe fays. This has happened to her feveral times for this month paft, and held her a full quarter of an hour. She has been bled in the foot the three laft attacks, and every time it has immediately removed the fit. She has never been irregular. The fits have returned about a week ago, with the fame fymptoms, and come often. The patient cannot be bled every time. Is there no other method therefore to be made ufe of inftead of the bleeding?

Anfwer.

The anti-hyfterics prefcribed by feveral authors, and the manner of ufing them, are fo well known, that I fhall not mention them. I fhall confine myfelf to making known to you what I have done in thefe kinds of fits, having always obferved that the imagination has more concern in them than any fault in the fluids. The following is what I have found always fucceed, and has fo immediate an effect, that they have ceafed almoft inftantaneously.

A lady was in the abovementioned way, and having bled her in the foot, in many of thefe convulfive attacks, inftead of bleeding her again, I applied a cupping-glafs to the infide of her thighs. The fkin had hardly rofe into the glafs when the fit diminished, and in two or three minutes intirely ceafed.

I applied the cupping-glaffes in the fame manner, more than twenty times in fix months in the like attacks, and the fuccefs was every time as expeditious, till at length they entirely left her. I leave to the learned in phyfic to explain how these cures were performed without any evacuation or medicine.

A young woman of eighteen was troubled with violent convulfive fits, of the fame kind as thofe I have mentioned. I REY, Nov. 1766.

made her put her legs in warm water to bleed her in the foot, and in an inftant after, even before the vein was opened, the violence of the fit abated; nevertheless I bled her, and the fit intirely ceafed. However this did not prevent her having four attacks of the fame kind within a week after. The three firft went off by bleeding in the foot, but upon a fourth coming on more violent than the former, I applied a cupping-glafs to thenavel; the fit went off in lefs than two minutes, and she has had none fince.

It is not impoffible but the conftitution, together with a lively imagination, contributes a good deal to thefe fort of fits, or may even be the cause of them. A fudden fuppreffion of the catamenia, by any unforeseen accident, or only a diminution, may equally occafion them. In thefe laft cafes, bleeding in the foot is of great fervice in fupplying the place of them, or promoting their return. But when it is owing to the imagination, the bleedings are not of fo much ufe, as we have just before obferved. They relieve, it is true, for that inftant, but bleeding fo often might prejudice the conftitution. The application of cupping-glaffes has put a stop to them as well as bleeding, and I have made use of them fo often with fuccefs, that I do not ad→ vife any other thing.'

In this manner Monf. le Dran inftructs the young furgeon in the proper method of treating moft of the difcafes which require the affiftance of his art. By this method, he is not only taught how to act with regard to the patient committed to his care, but is alfo furnished with great variety of examples of the proper manner of relating cafes to a diftant furgeon, whofe advice is required. Though fome of our capital furgeons may, in a few inftances, have improved upon Monf. le Dran, this book may nevertheless be perufed with advantage, not only by young ftudents in the art, but even by a very confiderable number of thofe who believe themselves mafters in their profeffion; and though we might prefume, in fome inftances, to deviate a little from his inftructions, yet, upon the whole, his principles are found, and his practice fimple and rational.

The Fool of Quality; or the Hiftory of Henry Earl of Moreland ; Vol. II. Concluded.

T

Rue pictures of conversation, drawn from real life, are seldom to be met with in books. In the drama we do, indeed, frequently behold very good copies ;-but though our comic writers have been tolerably fuccefsful in this way, yet authors, in general, have failed: and it is not difficult to affign the caufe. It is, their want of acquaintance with the originals

S

Some of them are men who bury themselves in their studies, where they remain, fecluded from a free, open, extenfive commerce with the living world. Others are unhappily deprived of this advantage, by the narrowness of their fortunes, and ob fcurity of their fituations and a third clafs are thofe fcribbling coxcombs, who are mere pretenders to wit and parts which they poffefs only in their own fond imaginations. In respect to the firft, their colloquial writings are ufually too much stiffened with academical buckram, and totally deftitute of that grace and ease which are rarely to be met with, except in the converfation and literary compofitions of those to whom men, modes, manners, and characters, are intimately known, and who are familiarly acquainted with the higher walks of life. As for those of the fecond clafs, the poverty of their style and diction is generally of a piece with their indigent circumstances ;- and, in regard to the laft, we have nothing to expect from them but affectation instead of elegance, and flippancy inftead of freedom: while frivolous or frothy conceits take place of that genuine fpirit, manly fenfe, and liberal manner, which diftinguish the gentleman and the genius from the fop and the witling.-How far Mr. Brooke, the ingenious author of the entertaining work before us, will be diftinguished from all or any of the three claffes we have pointed out, our Readers are, in fome degree, enabled to judge, from the fpecimen we gave of his performance, in our laft month's Review; where, at p. 297, we were, for want of room, obliged to break off, abruptly, in the middle of the animated conversation that paffed at the countefs of Maitland's we shall now give the remainder.

Mr. Faddle's remark on the confcientioufnefs of libertines, faid Mr. Fenton, reminds me of Jack Wilding, a quondam acquaintance of mine. I had the ftory from himself; it is an adventure of which he boafted; and the recital, in his opinion, did by no means detract from his character, as a gentleman.

Mr. Wilding was of a neighbouring country, and was educated by pious parents in a fcrupulous obfervance of his duties to God and man. When they thought him confirmed in his civil and religious principles, they fent him here to study our laws in the Middle Temple; where he fpeedily learned that pleasure was the only good, and that the laws of nature were irreversible by any fubfequent appointments. However, he piqued himself extremely on what is called the punctilio of ho nour, and would run any man through the body who should intimate that he had been guilty of an unjuft or ungenerous `action.

Wilding was a young fellow of parts and pleafantry, and d a very fpecious appearance of virtue. A confmerchant conceived a friendship for him; and, A a 2

when