General surgical pathology and therapeutics : in fifty-one lectures / by Theodor Billroth ; translated from the fourth German edition, with the special permission of the author, and revised from the eighth edition, by Charles E. Hackley.

  • Billroth, Theodor, 1829-1894. Allgemeine chirurgische Pathologie und Therapie. English
Date:
1881
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Licence: Public Domain Mark

Credit: General surgical pathology and therapeutics : in fifty-one lectures / by Theodor Billroth ; translated from the fourth German edition, with the special permission of the author, and revised from the eighth edition, by Charles E. Hackley. Source: Wellcome Collection.

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

    762/806 (page 736)
    The oval amputation was first made by Scoutetten. You will find very accurate accounts of amputations in SpreyireVs histories of operations, and in Linhart's excellent work on operations, which I cannot too highly i-ecommend. RESECTIONS. I will now make a few general remarks on resections. As ])revi- ously stated, sawing, chiseling, or gouging out diseased or injured pieces of bone from the body of the bones, is called “resection in the continuity.” Most operations of this nature were mentioned when treating of comjjlicated fractures, necrosis, or caries; as were the so-called osteotomies for orthopedic purposes. You will see these operations so often in the clinic that I will not describe them here; they are mostl}’ simple. The indications for them appear from what has been said. \Ye have also spoken of “ resections of joints.” I have alread\' told you that these operations, which in civil practice occur espe- cially for caries, have different results and indications for each joint. The same is true of resections of joints in gunshot-wounds; each joint has its special resection history. Resections, especially resec- tions of whole joints, are of much more recent date than amputations. The first excision of a carious head of a humerus was made by ^Vhite, 1768 ; resection of the elbow-joint by Moreau^ 1782; of the head of the femur by ~WMte^ 1769; of the knee-joint by JPci7'lc^ 1762. But at first these operations Avere not popular ; they were said to be too difficult, tedious, and painful, and it was thought that the final results Avould not be good. It is only within the past thirty years that they have been accepted by surgeons, and the methods of their performance are still being improved. At first it Avas merely at- tempted to remove the affected jiortion of bone without loss of the limb, so that the parts might heal. Later, attempts Avere made to retain the function of the false joint left after the resection, by judicious selection of the lines of incision, method of operating, and after-treatment. Surgeons even went so far as to excise stiff joints that were all healed, so as to substitute for them movable false joints. Possibly, for a time, Ave held too hopeful views of Avhat was attain- able by these operations; but AA'onderful cures liaA’e been accom- plished, and with the increased attention uoav given to them Ave ma}’ e.xpect the indications, mode of operating, prognosis, and after- treatment to be more defined. In resections, the incisions should be so directed that no large vessels or nerves, and as fcAv muscles as possible, may be injured, and still space made for freeing the joint and saAving the bone.