Clinical notes upon two years' surgical work in the Liverpool Royal Infirmary / by W. Mitchell Banks.

  • Banks, W. Mitchell (William Mitchell), 1842-1904.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Clinical notes upon two years' surgical work in the Liverpool Royal Infirmary / by W. Mitchell Banks. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    the accident, so nearly dead, that it was only by hypodermic injections of ether and careful fostering of his strength, that he was tided over the night. By next afternoon he was so far recovered that amputation was performed through the middle third of the right thigh, the limb being irretrievably smashed. His strength was, however, too far gone to enable him to take advantage of the operation. The third case was that of a drunken cobbler, who was run over by a tramcar. He was a very bad subject indeed, with tissues completely saturated with alcohol. So that, although his left leg was cut off high above the injury, the flaps sloughed at once, he became violently delirious, and his oppo- site leg—the subject of a simple fracture, with severe general contusion—was seized with diffuse cellulitis, requiring extensive incisions. He had no stamina left to bear all this, and died exhausted on the tenth day. In these four cases there was nothing to regret. Amputation was a necessity forced upon the operator in order that the patients might have the benefit of the few remaining chances left to them, and death resulted from causes over which surgery at present has no control, seeing that human beings are only endowed with a limited amount of vis vitce. Of the Fourteen Successful Amputations, eight were per- formed for disease and six for injury. Of the cases of disease two were done for enchondroma. Amputation at the Shoulder-Joint for Enchondroma of the Humerus.—Samuel D. was a spare, placid man of 56, a chapel keeper. So far back as the summer of 1865 he was seized with a violent pain near the right shoulder, and after that there came a hardness and swelling at the top of the humerus, which very slowly increased. Very slowly, but very steadily, an enchon- dromatous tumour developed itself just beneath the deltoid. As it gave him no great inconvenience, he did not heed it much for many years; but by 1878 it had grown to be as big as a cocoa nut, so that, on attempting to raise the arm, it became locked against the acromion and limited movement, while pain of a severe character set in. In June of the same year (1878) the tumour was removed by cutting down upon it, and dissecting off the tissues from over it. As it grew from the outer surface of the upper third of the humerus, this was effected without difficulty. Then with a