I therefore proposed to some of the medical gentlemen of the hospital, who attended in consultation, that a seton-needle, armed with a skein of silk, should be passed through the arm, and between the fractured extremities of the bone, and that the seton should be left in this situation, until by exciting inflammation and suppuration, granulations should rise on the ends of the bone, which uniting and afterwards ossifying, would form the bony union that was wanting. This operation being agreed to, it was performed on the 18th of December, 1802, twenty months after the accident happened. Before passing the needle, I desired the assistants to make some extension of the arm, in order that the seton might be introduced as much as possible between the ends of the bone. Some lint and a pledget were applied to the orifices made by the seton-needle, and secured by a roller. The patient suffered very little pain from the operation. After a few days the inflammation (which was not greater than what is commonly excited by a similar operation through the flesh, in any other part) was succeeded by a moderate suppuration. The arm was now again extended, and splints applied. The dressings were renewed daily for twelve weeks, during which time no amendment was perceived; but soon afterwards the bending of the arm at the fracture was observed to be not so easy as it had been, and the patient complained of much more pain than usual whenever an attempt was made to bend it at that place. From this time, the formation of the new bony union went on rapidly, and, on the fourth of May, 1803, was so perfectly completed, that the patient could move his arm, in all directions, as well as before the accident happened. The seton was now removed, and the small sores occasioned by it, healed up entirely in a few days. On the 28th May, 1803, he was discharged from the hospital; perfectly well, and he has since repeatedly told me that his arm is as strong as it ever was.” To the preceding paper it is unnecessary to add, that the mode of treatment there stated might be adopted in similar fractures of other bones, provided a seton-needle could be passed near to the ends of the fragments, without any risque of wounding blood-vessels, nerves, or other parts of importance. It is thus that solitary facts minutely detailed and well substantiated, oftentimes grow into principles of extensive application. ARTICLE II. _An account of Dr. Physick’s improvement of Desault’s apparatus for making permanent extension in oblique fractures of the os femoris._ Dr. Physick having observed that in the application of Desault’s apparatus, the patient was sometimes injured by the pressure of the strap or roller _g g_ (plate 2) which passes under the tuberosity of the ischium for the purpose of making counter-extension, devised the following method of remedying this inconvenience, in which he succeeded to his wishes.