gone through, not yet beyond his thirty-fourth year.—Donor,
Edward Dillon, Esq.
E. b. 836. A section of the diseased texture which surrounded
the joint, 835, and extended for a considerable
distance up the thigh. It is white, gristly, and elastic, bearing
a strong resemblance to fibro-eartilage.—Idem.
E. b. 837. Knee-joint excised by Sir Philip Crampton, for
white swelling. This is the knee of Susan Conolly, case second,
plate ninth, as published in the Dub. Hosp. Reports,
Yol. iv. The preparation shows two and a half inches of the
lower end of the femur, and about one inch in thickness of
the condyles of the tibia : a third piece is suspended at the
top of the bottle, consisting of an inch of the shaft of the
femur, Removed, because diseased, by a second application of
the saw. The femur is in a state of necrosis; it is deprived
of its periosteum; the walls are as thin as card-paper, and
the medullary cells are loaded with pus: the bones are nearly
stripped of their cartilages ; and erosions from caries exist in
several places. The patient recovered from the operation,
and the great wound healed, but anchylosis was never accomplished.
She lived for three years and two months after—
her health, which was naturally delicate, being gradually undermined
by repeated attacks of erysipelas and pulmonary
disease.
Observations.—“ It is plain,” says Sir Philip, “ that this
operation, so far at least as related to the preservation of the
limb, completely failed. It served to prove, however, in the
most satisfactory manner, that the excision even of so large
an articulation as the knee-joint might be performed with
safety, and gave strong grounds to hope, that, under more
favourable circumstances, the operation might be attended
with success.”—Sir Philip Crampton, Bart.
E. b. 838. Second case of diseased knee-joint, extirpated by
Sir Philip Crampton, and published by him in the Dub. Hosp.
Reports, vol. iv. This joint is that of Anne Lynch. The
condyles of the femur and the patella were here, the only parts
removed in the operation. The appearances of tne joint are
much the same as those in the instance of Conolly : but the
femur, where divided by the saw, is healthy; the patella also
is comparatively little diseased; and the condyles of the tibia
were found by Sir Philip in so sound a state, that he contented
himself, when operating, with slicing away the cartilages
of incrustation. Great difficulties, arising mainly out of the
girl’s violence of manner, embarrassed and protracted the
operation. The same unmanageable disposition which showed
itself then, greatly interfered with her ultimate recovery:
tossing and turning with every new feeling of uneasiness, she
frequently caused protrusion of the femur through the wound.
And, notwithstanding all this, the only unfavourable occurrence
was a small exfoliation of the femur. In six months
after the operation the femur and tibia were consolidated by
a firm bony union ; and the woman, though timid beyond all
example, began to lay her foot gently to the ground, supporting
herself, however, on crutches. In eighteen months she
was able to walk many miles without pain or fatigue—the only
deformity being a bowing of the limb, outwards, and a shortening
of about four inches, the want of which she supplied by
a .cork-heeled shoe. It is now sixteen years since the performance
of the operation; and the poor woman, a grateful
pensioner on Sir Philip’s bounty, walks at stated intervals into
the city, from a distance of twenty miles, to receive her allowance
at his own hand, and to show him, exultingly, the perfection
and permanence of the cure.—Idem.
E. b. 839. Peculiar form of dislocation of the knee, the
result of long-continued disease. The femur is rotated on its
axis so as to present the external condyle in front, and the
internal one behind. The posterior surface consequently looks
directly outwards, and lies in close contact with the posterior