A description of the diseased conditions of the knee-joint which require amputation of the limb, and those conditions which are favourable to excision of the joint : with an explanation of the relative advantages of both operations as far as can be ascertained by cases properly authenticated / by Peter Charles Price ; edited, with a preface and memoir of the author, by Henry Smith.

Price P. C. (Peter Charles), 1832-1864.

Date:: 1865

Credit: A description of the diseased conditions of the knee-joint which require amputation of the limb, and those conditions which are favourable to excision of the joint : with an explanation of the relative advantages of both operations as far as can be ascertained by cases properly authenticated / by Peter Charles Price ; edited, with a preface and memoir of the author, by Henry Smith. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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Case 6.—In the summer of 1858, at the Cliildren's Hospital at Margate, I removed the knee-joint of a child who for years had suffered from chronic disease of the joint. The deformity in this case, and the condition of the parts, are seen in Cast No. 2.* The integument covering the articulation was riddled with sinuses, and the bones were firmly fixed at an obtuse angle. The health of the child, a girl, set. 12, was shaken, and the removal of the diseased joint was highly desirable. Some years previously she had been troubled with a continual flow of purulent matter through the rectum : this, however, had ceased, and now the only affection which prevented restora- tion to health was that of the joint. The operation was performed, and the child went on favourably. Reference to No. 3 dry preparation shows that a large cavity existed in the cancellous structure of the femur which opened into the joint. The synovial membrane was nearly all destroyed; the cartilages in parts were likewise removed. About two months after excision the little patient began to decline. The old mischief about the bowels was re-ignited. Diarrhoea was established, and purulent matter was mixed with the excretions. Instead of improving she gradually emaciated and sank, and during the time it was noticed that little or no union advanced. Eventually, the end of the femur was exposed by reason of the covering integument sloughing. After death j I removed the limb, and the parts immediately concerned in the operation of excision are pre- served in Preparation No. 2 (moist).$ It will be seen that the protruding portion of the femur is soft, and dead. Had this patient not been seized with the abscess some- At the same time we must not shut our eyes to the fact that amputation has in numerous cases been resoi-ted to merely for the purpose of removing a distorted limb, that death has occurred, and that no one has ever thought of casting blame upon the surgeon for performing what was supposed to be a very justifiable operation.—H. S, * This cast with the preparation was sent in with the Essay.—H. S. + Death occurred July 1st, 1859. I This preparation was sent in with the Essay.—H. S.

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