Quarterly report of the Edinburgh Surgical Hospital, from May to August 1829 / by James Syme.

  • Syme, James, 1799-1870.
Date:
[1829]
Catalogue details

Licence: Public Domain Mark

Credit: Quarterly report of the Edinburgh Surgical Hospital, from May to August 1829 / by James Syme. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    to meet with a similarly speedy and complete destruction of the large bones. It is true that some people who still believe in the possibility of dead bone being absorbed by the living ves- sels, or dissolved by the pus, may entertain a different opinion. This is not a proper occasion for entering on discussions re- specting necrosis, otherwise it might easily be proved that the whole shaft of a bone very rarely dies entire, and that, when it does so, there is either no reproduction, or the substitute has been formed more or less completely previous to the demise of its parent. In this case the destruction was not confined to the shaft, but extended into the knee-joint, contrary to the tenet of some writers, that the epiphyses are exempt from necrosis. There are several preparations in my museum which show the same thing, particularly one of a tibia, which was lately given me by my friend and former pupil. Dr Arrot. It was amputated by his brother in Arbroath, on account of extensive abscesses of the knee-joint. The exfoliation also which is now going on, notwithstanding the speedy and apparently perfect union of the flaps, is interest- ing as an indication of the tendency to die, which is occa- sionally observed in the whole osseous system. Every practical surgeon must have noticed cases where the shafts of almost all the bones of the body were affected with necrosis, just as their heads are at other times occupied by scrofulous caries. Amputation of the thigh.—William Macintyre, aged 54, entered the Hospital on 29th July, on account of a diseased state of the inferior extremity, which made him desirous to part with it. The foot presented an extraordinary appearance, being greatly enlarged, and strangely altered in form, so as to constitute a shapeless unwieldy mass, equally useless and un- seemly. He stated, that for the last five or six years he had suffered from repeated and almost uninterrupted attacks of in- flammation and suppuration of the limb, in the course of which most of the toes dropped off. There was still a large sore in the fore part of the foot, but most part of its surfaee, together with that of the leg, was covered with thick cicatrices. The patient suffered little, except from unwieldiness of the limb, owing to the weight of the foot, and stiffness of the ancle-joint, which, by preventing him from placing the heel on the ground, rendered progressive motion quite impossible, except by means of crutches, but he was rcndei’ed so unhappy by this state of help- lessness, as to desire the only relief which it was in our power to afford—removal of the limb. The thickened and indurated condition of the soft parts rendered it impossible to obtain a co- vering for the bones any lower than the highest practicable