Report of clinical cases treated in the surgical wards of the Royal Infirmary under the care of Mr. Spence during the session 1862-63 / by Arthur G. Reid.

Reid, Arthur G.

Date:: 1864

Credit: Report of clinical cases treated in the surgical wards of the Royal Infirmary under the care of Mr. Spence during the session 1862-63 / by Arthur G. Reid. Source: Wellcome Collection.

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$day ; she became jaundiced, and died on the eleventh day after the operation. 6. M. L. Gelatinous disease of the knee-joint, of eight years’ duration, ending in ulceration of the cartilages, and caries ,* limb flexed; sinuses into the joint; profuse discharge. Amputation through the lower third of the thigh, by the long anterior flap. Recovered. 7. J. W., set. 12. Necrosis of the whole shaft of the tibia, accompanied with a profuse fetid discharge, which escaped through several orifices. Ankle-joint anchylosed in an extended position. Patient very much emaciated, and extremely weak. Amputation through lower third of the thigh, by the long anterior flap. Although the stump, externally, looked perfectly healthy, acute necrosis had attacked the shaft of the femur, and on the fifth day a large subperiosteal vessel was opened into. The poor boy, mistaking the hsamorrhage from this source for the purulent discharge, gave no notice of the occurrence, and it was only in consequence of his becoming blanched and faint that the resident surgeon was sent for. The stump was laid open and the vessel seized hold of, but, on attempting to tie it, it gave way and retracted. The stump was then raised, cold applied, the patient carefully watched, and stimulants largely given. He was too weak to bear up against the loss of blood, and sank the next day. 8. C. Cn., get. 25, had suffered for eight years from strumous disease of the knee-joint, with ulceration of the cartilages and necrosis of the lower end of the femur. The pain had become so intense as to compel her to seek relief in large doses of laudanum. She was very much emaciated, and excessively weak. Amputa¬ tion by the long anterior flap. Secondary hgemorrhage from the femoral artery occurred on the eighth day ,* the alarm was imme¬ diately given, and Mr Spence, who was in the wards at the time, secured the vessel. During the succeeding fortnight the stump healed rapidly, and the wound was almost completely united, when rigors set in ; these were followed by the usual symptoms of pyasmia, which proved fatal in the fifth week after the operation. Leg. 1. R. A., get. 43. Large callous ulcer, involving nearly half the internal surface of the leg. The patient had been subjected to a great variety of treatment, ending in temporary relief. As it was impossible to obtain a sufficiently long posterior flap, it was neces¬ sary to cut a short anterior flgxp from the front of the leg. The wound healed readily, and the patient never had an unfavourable symptom after the operation. 2. A. A., get. 50, Six years ago he sustained a compound fracture of the lower end of the tibia, communicating with the ankle-joint. After prolonged treatment, the parts united: but he was never able to make much use of the limb. Pieces of bone had$