On the surgery of the knee-joint : and the responsibility placed on the physician and general practitioner by the modern progress of surgery : being the inaugural and retiring presidential addresses delivered before the West London Medico-Chirurgical Society, on October 7th, 1887, and May 4th, 1888, respectively / by C.B. Keetley.

  • Keetley, Charles Bell, 1848-1909.
Date:
[1888]
Catalogue details

Licence: Public Domain Mark

Credit: On the surgery of the knee-joint : and the responsibility placed on the physician and general practitioner by the modern progress of surgery : being the inaugural and retiring presidential addresses delivered before the West London Medico-Chirurgical Society, on October 7th, 1887, and May 4th, 1888, respectively / by C.B. Keetley. 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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    to this day too frequently taught and practised. Let anyone study carefully the facts and opinions on chronic disease' of the knee-joint to be found in the handbooks and monographs of ten years ago, and he cannot fail to see that in those days, recent as they are, the rich man with chronic knee-joint disease who submitted to an operation was little better than a fool, while the poor man who was operated on in order to get independence and the means of earning a living for himself and his family was a hero. In short, ten or twelve years ago, it was the practice, and then the correct practice founded on the experi- ence of the time, to tell a patient with a diseased knee, if he was no longer quite young, that his choice lay between, on the one hand, immediate amputation of the thigh, and, on the other, a long, tedious pro- cess of treatment, very likely involving three, five, or even ten years’ incapacity for following his employ- ment, and, as likely as not, ending in amputation after all. He had also to be told that his chances of life and death after amputation were no better than two to one* If the patient were a child or an adolescent, not very different information could be honestly given. Amputation at that age was com- paratively safe, but excision was still very dangerous. Of ninety-seven cases collected by Bryant, twenty- seven died. Scarcely less serious were the long periods required for treatment after excision. ‘ Roughly speaking, the * Brvant’s statistics of 119 amputations in patients between the ages of twenty and forty. See Erichsen, vol. 11., p. 272 (date 1877).