Volume 2

Elements of surgery / by Robert Liston.

  • Liston, Robert, 1794-1847.
Date:
1831
Catalogue details

Licence: Public Domain Mark

Credit: Elements of surgery / by Robert Liston. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

    324/350 (page 314)
    and profuse discharge, and by distinct grating being produced on motion of the joint. In such circum- stances, amputation of the finger above the diseased part is fully warranted. But if the patient is obsti- nate in refusing to submit, or if he is in that rank of life where stiffness of the finger is of no great conse- quence, the member should be kept steady in a con- venient position, so as to favour anchylosis of the dis- eased joint. By splints and bandaging it is preser- ved in a state of semiflexion, that, after the cure by anchylosis, it may not be in the way when the patient lays hold of any thing, as it would be were it bent into the palm, nor exposed when the other fingers are bent, as must be the case were it kept quite straight. Still the finger is very useless—worse than useless—wheH*.stiff either from loss of the tendons or from destractibrrBf the joint; and more particularly wiien its position is awkward. So much inconve- nience does it give rise to, that patients, who pe- remptorily refused amputation whilst the case was recent, often return after a tedious, painful cure by anchylosis, soliciting removal of the deformed and annoying member. In severe cases of whitlow, all the fingers, the whole hand, and even the wrist, long remain rigid ; but the rigidity is gradually dissipated by friction, and by motion, at first gentle and passive. Chronic thickening and contraction of the palmar aponeurosis occurs occasionally, and, in some cases, to such an extent as to disable the hand almost entirely. The fingers are permanently bent, the palm is hard, and the integument puckered. The most severe ex-