. The collected papers of Joseph baron Lister . arning to work at a sewing-machine, and foundher hand thoroughly useful for the purpose. ON EXCISION OF THE WRIST FOR CARIES 423 Case 5.—Thomas M , aged twenty-one, a miner, was admitted on the 8th of July, 1864. About six months before, when suffering from small-pox, he was seized with inflammation in the right tibia and the left carpus,resulting in necrosis of the former and caries of the latter. When he cameinto the hospital the back of the wrist was swollen, and presented two sinusesthrough which a probe could be passed down to the diseased b
. The collected papers of Joseph baron Lister . arning to work at a sewing-machine, and foundher hand thoroughly useful for the purpose. ON EXCISION OF THE WRIST FOR CARIES 423 Case 5.—Thomas M , aged twenty-one, a miner, was admitted on the 8th of July, 1864. About six months before, when suffering from small-pox, he was seized with inflammation in the right tibia and the left carpus,resulting in necrosis of the former and caries of the latter. When he cameinto the hospital the back of the wrist was swollen, and presented two sinusesthrough which a probe could be passed down to the diseased bone. The handwas extremely feeble, and drooped when the arm was extended was very painful, interfering seriously with his nights rest, and his generalhealth was otherwise much deranged, his pulse being 135, and his appetiteimpaired, while he was constantly bathed in perspiration. On the i6th of July I extracted some exfoliations from the affected tibia,and also removed from the wrist the parts represented in Fig. 2. A carious. Fig. 2. cavity occupied the place of the semilunar bone, and the adjacent part of thecuneiform was excavated. The other carpal bones, except the trapezium,were anchylosed into one mass. Two days after these operations his pulsehad fallen eleven beats, and after two days more he was recovering his appetite,and had lost his perspirations, while his former anxious expression was exchangedfor that of cheerfulness. The improvement in his general health continued,and the hand made most satisfactory progress. Six weeks and six days afterthe excision it was soundly healed, and the swelling had entirely could move all the joints of all the fingers and both those of the thumb, andperformed to some extent all the natural actions of the wrist. A fortnight laterhe stood the test of lifting a weight of six pounds and a half with the unsup-ported hand in the horizontal position of the forearm. In No\omber, fourmonths after the operation,
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