Quarterly report of the Edinburgh Surgical Hospital, from November 1829 to February 1830 / by James Syme.

  • Syme, James, 1799-1870.
Date:
[1830]
Catalogue details

Licence: Public Domain Mark

Credit: Quarterly report of the Edinburgh Surgical Hospital, from November 1829 to February 1830 / by James Syme. 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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    In the only other case of this accident I ever liappened to see, the surgeon found it necessary to divide one of the lateral ligaments of the joint. Dislocation of the Jaw.—There was one case of this disloca- tion in a woman who had previously suffered the same accident. Mr Smith reduced it in the usual way. Eoscision of the Elboic-Joint.—Little more than a year ago, in November 1828, I cut out a carious elbow, for the first time the operation was ever performed in Great llritain. Since then I have operated in six cases. The profession, I am happy to say, seem to be satisfied with the weight of this evidence, and at least two operations of the kind have been lately performed by different practitioners in Edinburgh. Five of my cases have already been put upon record through the medium of this Jour- nal, and I will now relate the other two. Elizabeth Johnston, ast. 15, from Falkirk, entered the Hos- pital on the 26th of August, on account of a disease of the right elbow-joint, which had existed for six months, commenced spontaneously, and increased progressively, notwithstanding the efforts of her medical attendants. It now presented a most formidable appearance, the joint being so much swelled as to measure thirteen inches in circumference, and the arm above being reduced to little more than skin and bone, which made the enlargement seem even greater than it really was. The skin over the olecranon was extensively ulcerated, and at different places, both on the front and back parts of the joint, the probe could be passed into sinuses which extended to the bones. The limb was straight, and nearly immoveable. The discharge was pi*o- fuse, the pain unceasing, and the irritation so great that the patient’s health seemed rapidly sinking. It was plainly neces- sary to do something effectual for her relief, and both Dr Bal- lingall and I, though entertaining the most favourable opinion of excision, from what we had seen of its good effects, resolved that any operation short of amputation would be inexpedient in this case, where there was such extensive disease not only of the bones, but also of the soft parts. Being, however, very averse in general to amputating the arm for caries, and feeling particular reluctance to mutilate this unfortunate girl, who was distinguish- ed by the most amiable disposition and interesting appearance, I delayed the operation. In the course of ten days, whether it was owing to a real improvement proceeding from the free vent which had been afforded to the matter by incisions, or was merely the effect of familiarity with the appearance of the joint, I fancied that it was not so hopeless as at first believed, and re- solved to make an attempt at excision.