About a month afterwards, the swelling returned, and, having continued for three months, disappeared again, when the body was found at the external side of the rotula, increased in size. Sundry external applications were tried for six months without success. Weary of this unavailing practice, the patient came, in March, 1791, to consult Desault, who discovered a cartilaginous substance of a flat and circular figure. Its usual situation was at the external side of the joint, but it could be easily moved to the internal side, and could be turned on its own axis within the joint, nor did it occasion any pain, when suffered to remain at rest by the side of the rotula. But, when it passed behind the tendon of the extensor muscles, the patient was unable to stand, and he experienced severe pains when it made its way under the condyls or behind the rotula. The indication was evident. Before the operation Desault prepared the patient by a proper regimen, and then, in the method already described (28), extracted a foreign body, whitish, and oval, fourteen lines in length, ten in breadth, and two and a half in thickness at its middle. It consisted of three pieces, united by a ligamentous substance, and was smooth on the side next the joint, but rough with irregular tubercles on the opposite side, and on its circumference. There was no loss of blood during the operation: the usual dressing was applied, after the most attentive examination, as to the existence of a second body. Neither pain nor swelling supervened, and by the fourth day, the reunion was complete. In a short time motion was performed with as much ease as before the occurrence of the complaint. In the mean while, a degree of uneasiness remained in the joint; but barely perceptible at first, this uneasiness continued to increase; in about four months, symptoms of the existence of another foreign body made their appearance. M. Vielle being now a distance from Desault, put himself under the care of his brother, who extracted a second body, in the manner already described, except that the incision was made at two strokes. Dressing the same as in the preceding case, with this additional precaution, that the thigh and leg were covered by a roller, for the purpose of moderating the action of the muscles. No fever, no pain; the reunion completed on the eighth day, except a small point in the centre of the wound, which suppurated slightly till the fourteenth. There was now neither difficulty in walking, nor the least sensation of pain. Since that time, M. Vielle has enjoyed the entire use of his limb. OBSERVATIONS AND REFLECTIONS ON FORMS OF APPARATUS FOR FRACTURES OF THE LEG. § I.