Case of traumatic spreading gangrene after severe compound fracture of the leg : for which amputation beneath the trochanters was performed and the arteries secured by four acupressure needles... / by P.D. Handyside.

  • Handyside, P. D. (Peter David), 1808-1881.
Date:
[1860]
Catalogue details

Licence: Public Domain Mark

Credit: Case of traumatic spreading gangrene after severe compound fracture of the leg : for which amputation beneath the trochanters was performed and the arteries secured by four acupressure needles... / by P.D. Handyside. Source: Wellcome Collection.

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    the escape of pus this morning returned, when a little remaining purulent matter was pressed from the posterior part of the flaps. .18th,—Dr Todd writes : “The fever not so high ; both wounds discharging a good deal of pus.” 19^A (seventh day).—“ Pus very much lessened. He still takes the Aconite mixture, but not so frequently, nor in such large doses.” 20th (eighth day).—Pulse 106; skin cool; has an appetite and relish for food ; ordered an advance in diet; a little pus escapes from the posterior, now the only, opening in the cicatrice. 21s£.—Stump contracting firmly. Has slept soundly. 22d.—Pulse 102, soft and regular; stump looks well. 23<i (eleventh day).—Pulse 100, stronger. 24th.—Pulse 98 ; tongue clean. 28th.—Passed a restless and sleepless night from neuralgia in the stump connected with indigestion. Pulse 100. The stump is im¬ proved in appearance. 29th (seventeenth day).—Tongue clean ; pulse 90 ; neuralgia gone ; appetite good. Ordered some wine daily. Sat up to-day. 30th.—Still improving. Towards evening Dr Todd was sent for to see the patient, whom he found in an unaccountably depressed state, thinking himself dying. Pulse 104, very weak and small ; tongue dry and furred; states that he has no complaint; stump looks quite well. Additional wine ordered, to be followed in an hour with a full dose of opium. These acted well. 31s£.—Patient entirely recovered from yesterday’s nervous de¬ pression. Pulse 90 ; tongue clean. Aug. 2 (being twenty-first day after the operation).—I this day visited M‘-for the fourth time, and found him in excellent health. His stump was healed, firm, and of a rounded form; so that I took a plaster cast of it with perfect ease to the patient.1 7th.—Patient well, and improving daily in strength and bulk. Stump sound and strong. He has since grown fat, and become an adept with the crutches, walking much faster and better, he says, than he could have done with his legs. He is preparing to enter a business establishment. Upon the foregoing case it may be remarked,— First, No room exists for any difference in opinion with the re¬ spected practitioners whom I met in consultation, who agreed that had the parents of the patient given their consent, primary amputa¬ tion was the wise course to have adopted. That this was a clear case for such a step, both its previous history and the dissection of the removed limb afford ample proof. The condition, however, of the latter,—in which the scalpel laid bare extensive ecchymosis, with 1 This cast, marked with the points of entrance and exit of the four Acu¬ pressure needles employed, is now in the Museum of the Royal College of Surgeons here. The accompanying Woodcut exhibits the points and lines of transfixion of the flaps.