. The principles and practice of surgery. eforgotten, however, that excision, in cases of injury involving theshoulder-joint, is generally practised when the lesions, and, conse-quently, the disturbance of the general system, are moderate. Amputation of the Arm, including the Scapula.—This ampu-tation was first performed by Cummings in 1808, for a gunshot patient made a complete recovery. Since the date of this opera-tion, amputation has been made at the scapulo-clavicular articulation,or through some portion of the clavicle, about 14 times, and, with theexception of Mr. Fergussons
. The principles and practice of surgery. eforgotten, however, that excision, in cases of injury involving theshoulder-joint, is generally practised when the lesions, and, conse-quently, the disturbance of the general system, are moderate. Amputation of the Arm, including the Scapula.—This ampu-tation was first performed by Cummings in 1808, for a gunshot patient made a complete recovery. Since the date of this opera-tion, amputation has been made at the scapulo-clavicular articulation,or through some portion of the clavicle, about 14 times, and, with theexception of Mr. Fergussons case, in which he operated for a malig-nant disease of the scapula, I do not know of one who has died eitherdirectly or indirectly in consequence of the operation. On the 12th of December, 1870, I operated on George Hanna, ofBarton, 1ST. Y., by amputation of the arm and scapula. The history ofthis case is as follows :— New York Medical Journal, January, 1862, p. 433, Dr. Rogers tables. 358 AMPUTATION OF THE ARM AND SCAPULA. Fig. In September, 1864, Hanna was hit upon the back, near the lowerangle of the right scapula, by a hard lump of earth, causing severe painfor several hours. Two weeks later the same point was again injuredby the chafing of a rope in supporting a bale of hay, and on the follow-ing morning he noticed a very hardswelling at the point of injury, of thesize of a hens egg. The tumor contin-ued to increase in size, unaccompaniedwith discoloration, until the 15th ofFebruary, 1865, when it was as large asa quart bowl. At this time the tumor,with a portion of the anterior border ofthe scapula, was removed by the wound healed in 28 days, and hishealth remained as good as before theoperation. January, 1868, after expo-sure during very inclement weather,the tumor began to appear again, andon the 12th of February following itwas removed by the knife, with a smallportion of the scapula. Before thiswound had closed a swelling occurredupon the upper arm
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