Contributions to practical surgery / by William Stokes, jun.

  • Stokes, Sir William, 1839-1900.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to practical surgery / by William Stokes, jun. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    24/28 (page 20)
    on this week, the seventh after the operation, she gradually sank, and died on the 15th of June. In considering the features of this case, I cannot avoid coming to the conclusion that had the operation been performed at an earlier period of the disease, before the ])atient’s vital powers became undermined by long-continued suffering, the result would have been probably very different, and I regret—and think it right to record that regret—that I did not perform the operation when the patient first came under my care at the end of last February. We should not wait until resection becomes nothing more than an alternative for amputation. “ Do not the very circumstances,” observes Dr. Watson, of Glasgow, “which demand the-amputation, diminish the likelihood of success from excision? Surely, then, the two operations ought not to be canvassed at the same time. If it is the time for amputation, then it is too late to attempt the salvation of the limb by excision; and if the latter course is at all a desirable one, then ought we to pursue it before the patient’s case has become well-nigh desperate. I believe it has been by acting too rigidly on the opinion that excision was a mere substitute for amputation, that we have had such poor success with our cases in Glasgow, and if I am not very much misinformed, surgeons elsewhere have not so acted, but have chosen cases for excision that were by no means ready for amputation. I think that we should do so too—that we should select patients who have some health and strength to Avork upon, as the subjects of this operation, and not those who are already sinking into the grave.” In concluding this brief record, I should be failing in duty Avere I to omit expressing my AA'arrn thanks to Messrs. Cooke, Locke, and Crossly, our clinical assistants in the surgical Avards of the hospital, for their care, and untiring zeal and energy, not only during the progress of the case I have just recorded, but in all those they had under their care since they Avere appointed to the offices they recently so Avorthily occupied. IV. Resection of Metatarsal Bones.—1 shall conclude this clinical report on the resection of joints and bones, by briefly adverting to a case of very chronic strumous disease of the meta- tarsal bones, Avhich Avas under my care last September, and for Avhich the operation of resection Avas attended Avith the happiest I’esults. The folioAving are the leading particulars of this case: Matthew Davis, aged sixteen, a boy of very strumous habit, was