But the experience of Desault demonstrates to us here, as well as in the preceding cases, the great extent to which we ought to carry our confidence in the powers of nature, when skilfully guided by the hand of art. The following case was communicated to me by Leveille. CASE IV. John Baptist Landrin, a postilion, aged thirty-six, was brought to the Hotel-Dieu, on the 19th of February, 1791. On the morning of the same day, a horse on which he was mounted having fallen, his foot was caught under the belly of the animal. As soon as he was disencumbered of the vast weight, he endeavoured to rise, but in vain. The pains which he experienced in his foot were extreme. He was carried home, where some surgeons, having ascertained that his foot was luxated, but being unable to reduce it, sent him to the Hotel-Dieu. Desault on examining him, found the bones of his foot to be situated as follows. The internal part of the os calcis corresponded to the lower extremity of the tibia: the back of the foot was directed outwards, and its external edge downwards: under the skin and in front of the tibia was the astragulus, resting on the scaphoide and first of the cuneiform bones, where it formed a considerable projection: on the back of the leg, the fibula corresponded to the tendo Achillis. The pains had been inconceivably great from the moment of the accident. Imboldened by numerous instances of success in similar cases, Desault, notwithstanding the extent of the disease, attempted the reduction. One assistant took hold of the superior part of the leg to make counter-extension, and another, for the purpose of extension, grasped the metatarsus with one hand, and the heel with the other. While these were pulling in different directions, the surgeon applying his thumb on the astragulus, endeavoured to force it into its place. His efforts were ineffectual: the opening through the capsule of the astragulus being too narrow, would not suffer it to pass. Desault perceiving this, cut through the integuments which covered the bone, and having laid bare the capsule and the ligaments which strengthen it, made an incision into them of a sufficient extent, taking care to avoid the tendon of the tibialis anticus, which was brought into view. The openings being thus enlarged, admitted of an easy reduction, and all the parts resumed, without difficulty, their natural situation. The reduction being effected, the wound was closed, and covered with some lint. A square compress was then placed on the back of the foot, while a long one was applied to its sole, and the whole secured by an apparatus similar to that described in the preceding case. The patient was confined to a very strict diet, and ordered to use diluting drinks.