Desault was called to the patient, whom he found in a most deplorable state: the pains which he suffered were excruciating: the parts around the wound were greatly swollen; a general spasm affected the system: amputation was judged necessary, but was deferred till the symptoms should be mitigated. The limb was dressed: next day, a gangrene began to affect the foot, which was then separated from the leg by cutting the tendons: the ends of the tibia and fibula exfoliated; the wound healed, and the patient now enjoys, in part, the functions and uses of the leg, by means of an artificial foot, framed and fitted on by an ingenious mechanic. Had the limb been too hastily amputated while the patient was affected with general spasms, fatal consequences would probably have ensued.
APPENDIX.
ARTICLE I.
The following interesting paper, extracted from the Medical Repository, Hexad: ii. vol. i. p. 122 . . . 124, will give the reader a better idea, than he can receive from any other source, of Dr. Physick’s new and successful method of treating an old and obstinate fracture of the os humeri.
A Case of Fracture of the Os Humeri, in which the broken ends of the bone not uniting in the usual manner, a cure was effected by means of a seton. Communicated to Dr. Miller by Philip S. Physick, M. D.
“Isaac Patterson, a seaman, twenty-eight years of age, applied to me in May, 1802, in consequence of a fracture of his left arm, above the elbow joint, which had taken place several months before; but the ends of the bone not having united, rendered his arm nearly useless to him.
“The history he gave me was, that on the 11th of April, 1801, after having been at sea seven months, his arm was fractured by a heavy sea breaking over the ship. Nothing was done for his relief until next day, when the captain and mate bound it up, and applied splints over it. No swelling supervened, nor did he suffer any pain, Three weeks after this accident, he arrived at Alexandria, when the state of the arm was examined by a physician, who told him, that the ends of the bone were not in a proper situation. After making an extension, the splints and bandages were again applied. He remained in Alexandria four months, when, finding his arm no stronger, he left off all dressings, and went on board the New-York frigate as steward: in this capacity he remained near the Federal City six months, and by being under the necessity of using his arm as much as possible, he found the connexion between the ends of the bones became looser and looser, till, at length, the arm bent as easily as if a new joint had been formed at the place of the fracture. From the frigate he went to Baltimore, where an attempt was made by machinery to extend the arm, and keep the ends of the bone in apposition, by continuing the extension. Under this treatment he remained two months, but experiencing no benefit, he was advised to come to Philadelphia.