On amputation at the hip-joint / by Richard G. Butcher.

  • Butcher, Richard G. H., 1819-1891.
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: On amputation at the hip-joint / by Richard G. Butcher. Source: Wellcome Collection.

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    Though the operation was first considered in France, and numerous essays were written for the several prizes offered year after year, it is a remarkable fact in the history of surgery, that the operation should have been first put in practice in England—the operator being Mr. Henry Thompson, surgeon to the London Hospital. Larrey tells us he performed the operation twice in Egypt, and once while he was serving with the French army on the Bhine. He was encouraged to make these attempts to save his patients by the consideration that he had already preserved some lives by ampu¬ tating either both thighs, both legs, or both arms, or removing the humerus at the shoulder-joint. Larrey has also the merit of having first done the operation in this description of cases in which (with the exception of bad cases of necrosis, or of incurable disease of the higher part of the femur) it is more decidedly proper than any other, viz., gunshot injuries of the head, neck, and upper parts of the femur, with or without injury of the femoral artery, or, when the limb has been carried away by a shell or cannon ball too high up to admit of amputation in the ordinary manner. However, he also regards as fit occasions for amputation at the hip-joint, circumstances in which from gunshot violence the limb is seized or threatened with gangrene nearly up to the hip.—Mem. de Chir. Mil., T. ii., p. 185. Severe as the operation is, Larrey contends that if it ever proves the means of saving lives which are in danger it is an act of humanity. After this period many successful cases followed—- by Millingen, Brownrigg, Guthrie, Delpech, Orthon, Mott of New York, Wedomyr, Syme, Brice, Sir A. Cooper, and others; and taking the converse, the operation, even in the course in which it is indicated, has failed in the hands of some of the most eminent surgeons, amongst others Sir A. Cooper, Sir B. Brodie, Hupuytren, Mr. Guthrie, Baron Larrey, Blick, Cole, Delpech, Dieffenbach, Emery, Gensoul, Clot-Bey, Boux, Carmichael, and Pelikan of Wilna.—Cyclopaedia of Practical Surgery, p. 182. The successes of the operation in later years, I am persuaded, must in a great measure be attributed to the effects of chloroform, in averting the shock, and likewise to a careful selection of the cases operated on; no one now would think of removing the limb from the socket in scrofulous disease of the joint, yet it might be perfectly justifiable to excise the diseased head of the bone. Mr. Erichsen (Science and Art of Surg., 4th Ed., 1861, p. 59.), availing himself of the labours of Dr. P. Smith, and also of those of