A report on excisions of the head of the femur for gunshot injury.

Date:
1869
Catalogue details

Licence: Public Domain Mark

Credit: A report on excisions of the head of the femur for gunshot injury. Source: Wellcome Collection.

    10/156 (page 8)
    HISTORICAL REVIEW. On February 9th, 1769, thirty years after Morand had proposed the operation of amputation at the hip-joint, Charles White, F. R. S., one of the Corporation of Surgeons in London, and Surgeon to the Manchester Infirmary, read before the Royal Society of London, an account of a successful excision of the bead of the humerus, performed by him on April 14th, 1768, and, at the conclusion of bis paper, made this statement: I have likewise, in a dead subject, made an incision on the external side of the hip-joint, and continued it down below the great trochanter, when, cutting through the bursal ligament, and bringing the knee inwards, the upper head of the os femoris hath been forced out of its socket, and easily sawn off; and I have no doubt but this operation might be performed upon a living subject witb great prospect of success. This seems to have been tbe first formal proposition to excise the upper extremity of the femur.* Prior to this, however, in 1730, J. D. Schlichting had extracted the remnants of a carious head of a femur by dilating a sinus on the hip of a strumous girl of fourteen, long a victim of coxalgia.1 Other instances in which the diseased head of the femur was spontaneously eliminated or was extracted without a formal operation were reported by Vogel,2 in 1771, Kirkland,3 in 1780, and Hoffman,4 in 1782. In 1783, Mr. Joseph Bran- dish5 described a similar case, which is remarkable because tbe necrosis of the epiphysis was the result of a gunshot wound. The patient recovered. In 1786, Vermandois6 made experiments in excising joints of the lower animals, and repeatedly removed the head of the femur successfully from dogs. Chaussier7 and Koler8 undertook similar experiments, and found that decapitation of the femur in dogs was not more dangerous than the removal of the bead of the humerus. Petit-Radel,9 Wachter,10 and Rossi,11 about this time advocated the operation, and described methods for its performance oh the human subject, the two former recommending a longitudinal incision over the great trochanter, as suggested by Charles White, while the latter advised that the articulation should be laid open by raising a triangular flap. In 1806, Dr. James Jeffray,12 of Glasgow, published a description of the chain saw * The paper is recorded in the PhilosojMcal Transactions for 1769, Vol. LIX, p. 45, and is republished the following year in Charles White's Cases in Surgery, London, 1770, p. 66. 1 Philosophical Transactions, Vol. XL, 11, p. 270. 2 Vogel, Observations quasdam chirurgicas dcfendit. Kilise, 1771, and Bihl. Chir. du Nord. pp. 391, 393. 3 Kirkland, Thoughts on Amputations, etc., London, 1780. 4 GuNTHEit, Lehre von den blutigen Operationen. Abth. II. Leipzig, p. 204. ■'London Medical Journal, Vol. VII, p. 138. B Ancien Journal de Chirurgie Medecine et Pharmacie, T. LXVI, pp. 70, 200, Janvier, 1786. 7 Chaussier, Mem. de la Societe Med. d'Emulation, T. Ill, p. 399, and Magazin Encyclopedique, T. VII, p. 248. 8 Koler, Experimenta circa Regencrationem Ossium. Gottingen, 1786, pp. 84-94. Petit-Eadel, Encgclopedie Metltodique, T. I, Art. Chirurgie. 10 Waciiter, G. H. Dhscrtatio Chirurgica de Articulis Extirpandis, Groningen, 1810. pp. 91-94. 11 Rossi, F. Elements de Medecine Operatoire, Turin, 1806, T. II, p. 224. '-' Park and Moreau, Cases of the Excision of Carious Joints, Glasgow, 1806, p. 175.