In expectation therefore of affording him that relief, which could by no other means be procured, I judged it adviseable to make an opening into the tumor; which I did by incision into the most prominent and fluctuating part; upon which there immediately gushed out a large stream of thin florid blood, and at this instant discovered to me the true state of that disease; which, till now, could not be ascertained by any peculiar symptom distinguishable by the touch, or perceptible to the eye.
Seeing this, I immediately filled up the wound with lint and tow; and then proceeded, in as expeditious a manner as possible, to apply a tight bandage upon the thigh, near to the groin; and, lest this might accidentally break, I applied a second ligature below the first, and proceeded to amputate the limb upon the spot.
During the operation the man fainted, but soon recovered from this deliquium; and, without any bad symptoms, gradually recovered his rest, appetite, and strength, and is now in perfect health.
Upon a dissection of the thigh and leg, I discovered the following appearances:
A great part of the fleshy portions of two of the extensor muscles of the leg, to wit, the vastus internus, and crureus, were destroyed, with the subjacent periosteum.
Four of the muscles, whose uses are to bend the leg, and which compose the internal and external hamstrings; to wit, gracilis, semitendinosus, semimembranosus, and biceps tibiæ, together with that adductor and flexor muscle of the leg called sartorius, were removed at a considerable distance from the thigh-bone on its inferior part, and from the tibia and fibula on their superior parts; by which means a large bed or cavity was formed for containing the extravasation, which consisted partly of a fluid, and partly of a coagulated blood; but by far the greatest part of the coagulum had acquired so firm and fibrous a consistence and appearance, as nearly to resemble brown macerated leather in its colour and texture. The neighbouring muscles appeared livid and lacerated.
The os femoris was become carious on its inferior and posterior parts; and, at about an inch distance above the condyle of that bone internally, there arose a considerable exostosis.
The capsular ligament of the knee-joint was become much thickened, and contained about two ounces of a viscid yellow synovia.
The femoral artery, on its inferior part, just above its division into tibialis antica and postica, was diseased; which disease extended four inches upwards.
The coats of the artery were considerably thickened, and lacerated longitudinally.