Observations on amputation of the thigh : and on the merits of that operation as compared with excision of the knee / by William MacCormac.

  • Maccormac, William, Sir, 1836-1901.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: Observations on amputation of the thigh : and on the merits of that operation as compared with excision of the knee / by William MacCormac. 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.

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    Since the revival of excision of the knee by Sir WiUiam Fergus- son m 1850, the operation has been practised a large number of times, and although the materials are perhaps now available where- with to form a tolerably correct estimate of its value, there is almost no established surgical procedure regarding which such wide differ- ences of opinion exist, or about which controversy has more hotly raged. No one will be disposed to deny that to preserve a strong and useful limb, firmly anchylosed at the joint, at an equal risk to life, is in every respect more praiseworthy and more surgical than to lop it oiF with the knife, and that where its preservation is practicable, to amputate would be an opprobrium of surgery. Nevertheless, as I conceive it to be our paramount duty to endeavour to preserve human Hfe as well as limb, it becomes obligatory upon the surgeon to inquire not only into the abstract merits of every novel pro- cedure, but very carefully into the elffects it may have as to safety or otherwise. To this consideration 1 think every other should be forced to yield, and it is in the hope of adding something, however trifling, to the common fund of information, that I have ventured to place before the readers of this journal some observations on the question of amputation of the thigh, more especially in reference to excision of the knee-joint. The idea was partly suggested by the history of a case of disease of the knee in a young gH, whose limb I was extremely unwilling to sacrifice. She was a pretty, delicate creatui'e, only eighteen years of age, very thin, and very anxious-looking. She was first admitted to hospital, under my care, with simple synovitis of the right knee, in March, 1866, but had for several years been complain- ing from time to time of pain and uneasiness in the joint. After a month's treatment she was discharged relieved, only to be re-admitted a month afterwards. By appropriate means, and the opening of an abscess over the inner tuberosity of the tibia, she was again enabled to return home somewhat improved in health. At the end of September she sought admission a third time in much worse condition than before. A sinus leading to diseased bone existed where the abscess had been opened, and another had formed in the popliteal space. After trying various means without avail, an ex]:)loratory incision, cutting down upon the inner tuberosity of the tibia, was made, and a large quantity of carious bone gouged out. I hoped that the disease was subarticular caries, confined to this position, and the result for a time justified the expectation. The pain,