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Published: 2015-07-04

Total Pages: 596

ISBN-13: 9781330657683

Excerpt from Edinburgh Medical Journal, Vol. 1 of 10: Combining the Monthly Journal of Medicine and the Edinburgh Medical and Surgical Journal; July to December 1864 I at once coincided in the opinion which his medical attendants had expressed, although, from the depressed state of the young patient, and the proximity of the injury to the trunk, the chances of success seemed very small. The boy's parents having given their consent, I proceeded to perform the operation under circumstances not the most favourable. The room was small, and the only light procurable was from a small lamp on the mantelpiece, and two small candles held by a nonprofessional assistant; a wax taper I had brought with me was kept in reserve for exigencies. I had brought Lister's abdominal compressor, but as it could not be applied so as to command thoroughly the circulation, Dr Smith took charge of compressing the common femoral on the brim of the pelvis, and I instructed one of the patient's friends how to command the bleeding from the posterior flap, by grasping it with one hand and pressing a large sponge upon its surface. Dr Brown took charge of the movements of the limb, whilst Dr Clarkson administered the chloroform. When the boy was brought under its influence, I entered my knife between the trochanter major and the anterior superior spine of the ilium, and carrying it obliquely across the thigh, brought the point out a little above the tuberosity of the ischium, cutting a short anterior flap. Dr Brown then rotated and depressed the limb, with the view of facilitating disarticulation; but owing to the shattered state of the femur, this movement did not produce the desired effect. Fortunately, however, this caused no great delay, for my knife had opened the joint in passing across the limb; and by grasping the upper broken fragment of the bone, so as to project the head, I completed the disarticulation, and cut as large a posterior flap as I could obtain from the uninjured parts. Some vessels on the posterior flap were first secured, and then the great vessels in the anterior flap, - the vein being included in a ligature. I then removed some contused and doubtful-looking portions of muscle. After all bleeding had been arrested, the flaps were brought together with sutures; and considering the nature of the parts from which the flaps were formed, they fitted tolerably well. The stump was then dressed, and the patient placed in bed, hot bottles applied, and some stimulus given, as he was very weak. He lost very little blood during the operation, as I ascertained by carefully collecting the blood from the stone floor, when it was found to amount to less than half a small teacupful; and altogether, with what was in the sponges, to about five ounces at most. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.