Second case of excision of the knee joint, successfully treated / by William Keith.

  • Keith, William, 1802 or 1803-1871.
Date:
[1854]
Catalogue details

Licence: Public Domain Mark

Credit: Second case of excision of the knee joint, successfully treated / by William Keith. Source: Wellcome Collection.

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    on a pad or small cushion, which hindered rest, slept towards morning; re¬ adjusted the whole limb; it lies straight; the wooden platform steadies the frame admirably. The abscess in the ham is daily syringed out, it still yields pus copiously. May 29th, Monday, 12th day.—Has passed the most comfortable night of any since the day of operation. Appetite good ; tongue clean ; bowels regu¬ lar; pulse 120. The wound looks well, and the discharge is moderate. Meat allowed; continue wine. May 30th, Tuesday, 13th day.—Passed a quiet night; bowels moved at 4 a.m. Complains to-day of a sense of heat at and under the head of the fibula of the right leg ; fluctuation was detected along the line of that bone, without any redness or other sign of recent action ; an incision, four inches in length, was made along the whole extent of an abscess, and at least 2 oz. of thick pus escaped. May 31st, Wednesday, 14th day.—Slept pretty well; bowels regular. The abscess in the ham still discharges, and still accumulates a considerable quantity of pus daily. June 1st, Thursday, 1 5th day.—Made a free counter opening above the remains of the inner condyle of the femur, into the abscess which has so long existed in and around the popliteal space. Bowels open ; appetite good. June 2d, Friday, 16th day.—Slept well; feels comfortable. June 3d, Saturday, Vjth day.—Doing well; the discharge from the abscesses moderate ; the wound along the front of the joint is to-day united throughout its whole extent. Meat continued ; wine increased to 4 oz. daily; a scruple of phosphate of lime in combination with 5 grs. of sugar, to be given morning and evening. June 4th, Sunday, 18th day.—Feels well; allowed a pint of porter in addi¬ tion to his wine. June 10th, Saturday, 24th day.—Doing well in every way. He was for the first time lifted out of bed with his limb still in the fracture frame. June 13th, Tuesday, 27th day.—A sense of deep fluctuation at the upper and outer edge of the patella. A needle knife inserted has given vent to a tea¬ spoonful of ripe pus. The incision has been extended to a full half inch, and the cavity stuffed with lint soaked in turpentine liniment. The bowels rather loose ; stop the porter. June 18th, Sunday, 32d day.— Going on well; bowels regular. The wound of the operation firmly united. Porter allowed again. June 21 st, Wednesday, 35th day.—Feels as if he could lift his leg by his own effort, but is not allowed to try. He has no pain whatever on its being lifted out of the frame while being dressed. July 1st, Saturday, 45th day.—The joint looks very natural in shape and appearance. The skin of the whole limb is now healthy, from the daily inunction of citrine ointment. The health and appetite are good ; continue meat and wine, porter and phosphate of lime. July 20th, Thursday, 64th day.—Going on well. A sinus still open on the outside of the joint, occasioned by the last superficial abscess ; an opening and counter-opening are kept open by a small seton tape, run along the sinus. He feels strong and well. August 8th, Tuesday, 83d day.—He can now lift his limb out of the frame, supporting the thigh writh his own hands; the union at the joint thus bearing the weight of the lower limb, and this without exciting any pain. Health good; appetite keen. August 14th, Monday, 89th day.—Feels well. Removed the small seton. The old abscess in the ham having still the depth of an inch, was laid freely open with the knife, and stuffed with lint and turpentine. August 25th, Friday, 100th day.—Was out of bed yesterday, and with the aid of staves walked to the ward door; the first attempt he has yet made. Sept. 1st, Friday, 106th day.—Opened a small collection of pus at the inner