66. These considerations induced Desault to renounce his ancient mode of making permanent extension, and employ this exclusively, in the latter years of his practice. Like all other kinds of apparatus, formed principally of rollers, this is very subject to become relaxed; and requires, therefore, great attention on the part of the surgeon. It ought to be examined attentively every day, particularly the two extending bandages (L and g g). As soon as they become relaxed, they must be immediately tightened again: without this precaution, the effect of the apparatus will be lost. Be vigilant also, with respect to the compress placed between the roller (g g) and the tuberosity of the ischium. Should this slip, the roller being frequently tightened, and pressing immediately on the skin, may produce excoriations and ulcers difficult to be healed, particularly in females. The roller itself may slip, and then, having no longer a solid point of support and action on the tuberosity of the ischium, it makes extension in but an imperfect manner. 67. One of the charges brought against this apparatus is, the facility with which the upper roller becomes displaced, a facility that imposes a degree of care and attention, of which few surgeons are capable, and which, when bestowed even by Desault himself, did not always prevent the shortening of the limb. 68. Further, the extension made on the fold of the thigh, partakes, a little, of the inconvenience that accompanied the ancient mode of reduction, namely, that of compressing and irritating the muscles of the upper and internal part of the thigh (30). This inconvenience would be still more sensible, if, for want of extending to a sufficient distance up the pelvis, the upper splint should allow the roller to cross the muscles at an angle somewhat acute, as it would then enclose and press on the greater part of them. 69. If some unfavourable cases, resulting without doubt from these inconveniences, did occur in the practice of Desault, a multitude of successful ones still attest the advantages of this method; and there is not a pupil who attended any time at the Hotel-Dieu, without witnessing them. I will relate but one case, collected by Chorin, to furnish a detail of the treatment subsequent to reduction, referring the reader for further information to the Journal of Surgery. CASE II. Theresa Little-John, aged 45 years, fell, drawn by the weight of her own body, through a window in a balcony, from which she was leaning. She was instantly taken up, carried to her own house, and from thence to the Hotel-Dieu, which she entered on the 28th of October, 1790. From the signs mentioned (9), a fracture was discovered towards the lower part of the thigh; its oblique disposition required an apparatus to make permanent extension. This was applied in the usual manner, and, in an instant, the patient, who had experienced, since her fall, severe pain, became calm, and was completely relieved.