Transazioni del College of Physicians di Philadelphia . dal precedente scrittore che dà 48 morti, o nearly73 per cento., e 101 casi raccolti dal latterding 66 morti, o più del 65 per cento. Quando noi 92 ASIIHURST, confrontare queste cifre con il tasso di morte di amputa-tion in tlit: Il terzo inferiore della coscia per la lesione da sparo(55 per cento, secondo Legouest, 50 per cento, ac-cording to Me Leotl), non possiamo, credo, capanna indorsethe dictum di Guthrie che le ferite del knee-join*da musket-palle, con frattura dei hones che lo comporgono, richiedono l'amputazione immediata, e concludethai l'op

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Transactions of the College of Physicians of Philadelphia . by the former writer giving 48 deaths, or nearly73 per cent., and 101 cases collected by the lattergiving 66 deaths, or over 65 per cent. When we 92 ASIIHURST, compare these figures with the death-rate of amputa-tion in tlit: lower third of the thigh for gunshot injury(55 per cent, according to Legouest, 50 per cent, ac-cording to Me Leotl), we cannot, I think, hut indorsethe dictum of Guthrie that wounds of the knee-join*from musket-balls, with fracture of the hones com-posing it, require immediate amputation, and concludethai the operation of knee-joint excision should hebanished from the practice of military surgery. For lesions of the knee-joint from traumatic causesoilier than gunshot injury, excision might properly beattempted, if the patient were young and healthy, andthe destruction of pari-, comparatively slight. Thenumber of cases in which the operation has been per-formed under such circumstances is, however, toosmall to be of value for statistical use. EXCISION OF KNEE. 93. PACKARD, HODGE, EXCISION OF KNEE. 95 [After the reading of the preceding paper, J)r. John II.Packard said:—J I desire to call attention to a few points in reference to thesplint devised by me, and mentioned by Dr. Ashhnrst in his in-teresting paper just read. These points have not always beenobserved by those employing, or intending to employ, this splint:and yet the} are in my opinion so essential to its proper construc-tion, as well as to its effective and convenient use, that the neglectof them prevents a fair trial of the apparatus. The first point is to get an accurate outline of the limb, bylaying it on a large sheet of paper, and carrying a lead pencilaround it, from the greater trochanter on the outer side, up to theperineum on the inner. If the limb cannot be straightened, the out-line should be made on the paper by measurement; then, cutting outthe piece so defined, it should be tested and corrected by applyingit

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• bookcentury180
• bookdecade1870
• booksubjectmedicine
• bookyear1876