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.

    82/82 page 76
    the entire surface now: to continue the mixture containing hydrocyanic acid and morphia. 12th. Going on most favourably; pulse 100; wound free from all pain; no irritation about it; union has taken place, by first intention, in many parts along its edges, and the posterior flap is grown into the surface above, and consolidated through¬ out. Some healthy purulent matter can be pressed out from beneath the margins of the internal flap, and in the line of the ligatures. On this day I removed many of the sutures, being no longer required—their office fulfilled—and in a few days later the remainder were taken away. On the 16th, 23rd, 27th, and 29th, the ligatures were cast off; nothing could be more promising than the appearance of the limb. It is unne¬ cessary to continue the report day after day. On the 25th of March the parts were healed, and thoroughly consolidated throughout; and a more perfect or beautiful stump could not be produced (see Plate). I have made a very accurate cast of it, which contrasts remarkably with that of the deformed mem¬ ber, taken before operation. Both are in my private collec¬ tion, and it will afford me the greatest pleasure to show them to any one interested in such matters. Shortly after the above date I had a wooden-leg made for this man, properly fitted to the knee, and a more perfectly serviceable limb could not, by the most sanguine, have been expected. Before I conclude, there is one point that I would specially wish to insist upon, and it is this—that in all cases where a part is to be transplanted, the flap should not be handled much, compressed, or violence offered to it in any way; it should be seized with a spring-forceps, or held gently with the fingers, and elevated as the dissecting-knife frees it from beneath. By this measure alone can its vitality be insured, and a certainty obtained as to its accepting the union necessary to vitalize it in its new position.
    digitised image 1
    digitised image 2
    digitised image 3