Transactions of the College of Physicians of Philadelphia . pon moving the part. The appear-ance of the limb is well shown by the annexed illustration(Fig. 13), from a drawing by Dr. C. B. Xancrede. Enlarge-ment of the liver, and the presence of albumen in the urine,with the history of prolonged suppuration—the disease wasof eighteen months standing—rendered it probable that theviscera were affected with the so-called amyloid or albu-minoid degeneration; and this circumstance, together withthe anfemic and irritable condition of the patient, led mycolleague Dr. Hodge and myself to consider the
Transactions of the College of Physicians of Philadelphia . pon moving the part. The appear-ance of the limb is well shown by the annexed illustration(Fig. 13), from a drawing by Dr. C. B. Xancrede. Enlarge-ment of the liver, and the presence of albumen in the urine,with the history of prolonged suppuration—the disease wasof eighteen months standing—rendered it probable that theviscera were affected with the so-called amyloid or albu-minoid degeneration; and this circumstance, together withthe anfemic and irritable condition of the patient, led mycolleague Dr. Hodge and myself to consider the case as ill EXCISION OF KNEE. adapted to excision, and to recommend amputation in prefer-ence. Accordingly, the consent of the childs parents havingbeen obtained, the limb was removed at the junction of themiddle and lower thirds of the thigh, on September 20,1870,a long anterior flap being first shaped from without inwards,and a shorter one cut posteriorly by transfixion. Seven oreight ligatures only were required, and the stump was closed Fig. 13. A. with numerous points of the wire suture and dressed withlint saturated with pure laudanum. Convalescence followedwithout interruption; the wound healed by adhesion; thelast ligature dropped on the fourteenth day; and by thetwentieth day the patient was entirely well as regarded theoperation, though he was retained in hospital some timelonger for the improvement of his general health. The next case is the only one in which I have, asyet, had to deplore a fatal result after operation fordisease of the knee-joint. The case was one of a veryunfavorable character, but alter duly weighing all itscircumstances, and candidly placing- the risks of treat-ment before the patient, amputation was recommendedand accepted as offering- the only prospect of recovery. 70 ASHHTTEST, Case XIII. Acule Destructive Inflammation of the Knee-Joint in an Elderly Man ; Amputation ; Death on Eighth Day. —James W , an Irish laborer, fifty-one years of
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Keywords: ., bookcentury180, bookdecade1870, booksubjectmedicine, bookyear1876
