On excision of the knee-joint / by Richard G.H. Butcher.

  • Butcher, Richard G. H., 1819-1891.
Date:
1855
Catalogue details

Licence: Public Domain Mark

Credit: On excision of the knee-joint / by Richard G.H. Butcher. Source: Wellcome Collection.

    21/72 (page 17)
    and lips became covered with aphthous crusts; he suffered from cough and night-sweats, and sank in the course of a month after the operation. The wound was in a great part healed, and no difficulty had been experienced in keeping the limb in excellent position. Permission could not be obtained to exa¬ mine the body; but Mr. Mackenzie had little doubt that tuber¬ cular disease of internal organs would have been found. Case XX.—Next in order comes the case in wdiich I excised the knee-joint, January 20, 1854. I shall reserve it, however, to the last, being anxious to give all its details at full length. Case XXL—Mr. Erichsen excised the knee-joint from a boy, aged seven years, February 15, 1854. The patient was rendered insensible by chloroform. A first incision was made an inch above the inner condyle of the femur, along the side of the joint, to about an inch below the patella; a second incision ran across the leg; and a third parallel to the first, on the other side of the joint; the flap, including the patella, was then raised, and the lower two inches of the femur removed with the saw. The upper portion of the tibia was sliced off, and a portion of the outer part gouged away; the under sur¬ face of the patella was likewise scraped, the hemorrhage being altogether very trifling. Case XXII.—Mr. Pemberton excised the knee-joint for strumous disease, from a boy, aged 12, on the 8th of February, 1854. The extent of the tibia and femur taken away amounted to three inches and a quarter; the patella was preserved; the wounds healed slowly but perfectly, and a firm cartilaginous union binds the bones together. Case XXIII.—Mr. Mackenzie excised the knee-joint of a boy, aged 12, April 15, 1854, for caries of the extremities of the femur and tibia. Chloroform was administered; the pa¬ tient died twelve days after the operation. On post-mortem examination an ounce of purulent fluid was found in each pleura; numerous tubercular deposits were discovered in the apex of the left lung, and likewise a few at its base ; in the in¬ termediate portion of the organ, its structure was extensively disorganized, and readily broke down under the fingers. Miliary tubercles were scattered through the right lung, and at one spot, in the inferior lobe, there was a small cavity with slough¬ ing walls. Case XXIV.— On the 17th of May, 1854, Mr. Keith ex¬ cised the knee-joint from a boy, aged fourteen and a half years, of a very scrofulous diathesis, having numerous cicatrices of former strumous abscesses on both sides of his neck, both groins, and all around the ankle-joint of the right limb, the one from c