Cases of rheumatism terminating in suppuration, ca. 1821.
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Cases of Rheumatism terminating in suppuration -
1st. of a negro woman Louisa, belong-
ing, to my father - after exposure to
cold suffered pain in the extremities ;
The fingers were much swollen and
both ancles & knees. after some months
the pain & swelling left every part ex-
cept the right knee.
I first saw her in this disease on the
30th April 1819. Knee much swelled,
and incapable of motion. By resort-
ing to the ordinary means of leeching
cupping, blistering, and vss. & long con
tinued purging the pain in seven weeks
was entirely relieved, and the knee reduced
almost to the size of its fellow - about
this time I removed to Richmond.
In two months I returned & found by too early
discontinuance of the treatmt. the in-
flammation had return with great violence
and now suppuration had taken place.
Near two quarts were discharged by an
incision I made just above the knee
Extensive sinuses existed, one leading to
the groin. She now had hectic fever.
In consultation on the case Drs. Kleit &
I in favor of amputation - Dr. Hos-
kins & Dew, proposed to try alterative dose,
of calomel. I yielded to Dr Hs. experience,
and after six weeks returned when the
infl. had reached the body, thigh enormous-
ly swollen and I never again had the
opportunity of operating, - she died after
severe suffering, of colliquative diar-
rhea - June 1821.
Frederick [1 word illegible] 43 - a servant of Mrs. Camp
bell's suffered for months with marked
Rheumatism, which terminates
in suppuration and entire destruction of
of the structure of the knee - joint, ca
ries, great emaciation & hectic fever.
I visited this man at the request of my friend
Dr Hoskins in May 1820 & concurring with
him in the propriety, necessity of the
operation, I amputated the limb. He re-
covered most perfectly and now enjoys
good health - Decr. 1821 - suppuration of
the joint head existed more than 18 mos.
previous to the operation. I used animal
ligatures around all the arteries except two -
the femoral profunda - one of the silk
ligatures came away on the 16th day, the
other remained near six weeks, at the end
of wh. time the stump had almost entirely
healed. I had directed that the ligature shd
be slightly drawn every day, but they not
being attended to and adhesive plaister not an-
swering the purpose of keeping it tense I tied
a leaden bullit to it, and this brot the
ligature off in 24 hours - no accident I
thot. cd. result & no danger of hemorrhage
be apprehended as the cavity of the vessel
up to the last branch must long since have
been obliterated, from the stop put to
the circulation of the blood.