Second memoir on excision of the knee-joint : to which is appended a remarkable example of the power of operative surgery in saving the same articulation / by Richard G.H. Butcher.

  • Butcher, Richard G. H., 1819-1891.
Date:
1857
Catalogue details

Licence: Public Domain Mark

Credit: Second memoir on excision of the knee-joint : to which is appended a remarkable example of the power of operative surgery in saving the same articulation / by Richard G.H. Butcher. Source: Wellcome Collection.

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    dwelt, with great stress, upon the certainty of improvement in the condensation of the parts around, and in the vicinity of the excised joint, as time advances. Indeed, this circumstance was strikingly illustrated as regards the knee in many of the fore¬ going cases, and most remarkably so in Mr. Smith’s case, as recorded in the early part of this memoir; but in none so forcibly as in one of Mr. Fergusson’s cases, No. xx., the young woman operated on, March 1, 1856. She left the hospital cured; but the limb was not firm. I have received from Mr. Fergusson the gratifying intelligence of its perfect solidity now. In a letter dated January 3, 1857, with which he favoured me, he thus writes:— “My dear Sir,—This afternoon I learned from one of my dressers who has just been down to Portsmouth, that he had seen one of my cases, a girl on whom I operated ten or twelve months since. She made an excellent recovery; but at the end of four or five months there did not seem the least disposi¬ tion to the formation of bone. The change of air, however, has been most beneficial; and now the leg is firm, and she walks actively about without any assistance. There is still a small sinus open, but the case is perfect for the length of time. “ Yours, my dear Sir, with great regard, “ Wm. Fergusson.” In my former essay I gave abundant evidence that the danger of excision of the knee-joint is considerably less than that attending amputation of the thigh; and stated ample reasons why it should be so. By the mass of evidence just adduced the fact is confirmed. In my former essay I demonstrated, by numerous exam¬ ples, that the after utility and seemliness of the limb were vastly superior to any artificial substitute, no matter how beautifully contrived. By the mass of evidence just adduced, the fact is confirmed. In my former essay I forcibly dwelt upon the necessity of carefully selecting the cases for excision, and pointed out the prominent features which should influence the surgeon; but I believe the caution has not been applied in every instance. I fear the panting after eclat has charmed away some from the stern dictates of judgment; yet I trust this may never be the case—infinite mischief is done by such rashness. Not only is the life of the patient jeopardized by an operation which can¬ not secure a useful limb for the purposes of life, but the opera-