Case of painful crepitation in the course of the radial extensor muscles of the carpus / [Robert Knox].

  • Knox, Robert, 1791-1862.
Date:
[©1837?]
Catalogue details

Licence: Public Domain Mark

Credit: Case of painful crepitation in the course of the radial extensor muscles of the carpus / [Robert Knox]. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    irregular tumour, so that no doubt remained in my mind of there being an extensive effusion of air in the line of these muscles, either within the bursas mucosae, or in the cellular substance. It is natural to think that the air would collect first within the synovial membrane, but whether or not it ultimately penetrated into the cellular tissue, it is impossible to affirm. This case occurred nearly five years ago. I knew of no similar ones at the time ; but aware that those who practise most write least, I applied to several of my surgical friends to gain information on this point, but without success; some even doubted the possibility of the occurrence. A short time ago the circumstance was recalled to my recollection by the publication of portions of a very excellent memoir by M. Poulain. The original paper first appeared in thu Gazette Medicale, (parts 24 to 27,) from which judicious extracts were inserted in the Lancet of July, 1885. From this it would appear that the accident is rather a common one in Paris, and was originally discovered by Boyer — that it is frequently met with in the arms of blacksmiths, masons, wood- cutters, washerwomen, &c.; and that it has been met with in the sheaths of the peroneal muscles, as well as in those of the radial extensors. A reference is made by M. Poulain to M. Velpeau's writings for the fullest account of the disease. On referring to M. Velpeau's observations, and others, it would appear that such cases are not rare in France, and it will be interesting to myself, and perhaps to others of my fellow members, to learn from those having more ample opportunities for observation, if they have met with such cases —if they are frequent or rare—and if they get better, as mine did, without any surgical treatment, leaving, however, a slight pain, on exertion, in the affected part, and a weakness felt sensibly whenever the hand is carried violently from the supine to the prone state, or rather when this motion comes to be frequently repeated. It will hardly be necessary to remind the Society, that as yet there has been no analysis of the air formed in this very peculiar situation, and that its mode of formation is necessarily extremely obscure; in my own case, the air was most evidently produced by an action continued for many hours, necessitating, perhaps, a supply of synovia beyond what these forms ot bursas were equal to; when this anti-friction fluid failed, air was then poured into the synovial sheaths of the tendons; but all this is mere conjecture, and must continue to be so until an opportunity occurs of inquiring anatomically into the