to correspondents

1
181 CURE OF CONGENITAL CLUB-FOOT BY DIVISION OF THE TENDO-ACHILLIS. THOMAS INGLIS, M.D. To the Editor of THE LANCET. SIR :—Having observed of late several cases recorded in THE LANCET, of deformi- ties of the feet, cured by dividing the tendo achillis, I beg leave, in support of that very useful and simple operation, to publish my own case. I labour under contraction of the gas- trocnemii muscles of my right leg from my earliest years. When standing erect, my heel was about an inch and a half from the ground ; and when I walked, almost the only part of my foot that touched the ground was the ball of the little toe. I was obliged to use a stick, and suffered great uneasiness. I went to London, and placed myself under the care of Dr. Little. This gentleman, whose numerous operations of this nature have brought the subject of curing these deformities, surgically, fully under the notice of the profession, in your columns, suffered, as you are aware, from the same lameness, and had the operation of dividing the tendo achillis performed upon himself, by Dr. Stromeyer, in Hanover, the true inventor of the method, about fifteen months ago. Dr. Little, to whom I beg in this, the most pub- lic way in my power, to offer my grateful acknowledgements for his kindness and at- tention, while under his care, performed the operation in his usual skilful manner, on the 11th of August last. I sat upon a sofa, one assistant supported my knee, and another held my foot, and endeavoured to bend the ankle as much as possible, so as to render the tendon tense, while Dr. Little, resting one knee upon the floor, passed a narrow, curved bistoury across the tendon, between it and the deep vessels, nerves, and muscles, from within outwards, about two inches and a half above the os calcis, and divided it in withdrawing the instrument. As soon as the tendon was divided, it gave a crack, which was distinctly heard by all those around, and the separated ends of it could be easily felt with the fingers. The foot was bandaged, and allowed to remain at rest till the 14th, when the small puncture having cicatrised, the foot-board was ap- plied to make the necessary extension. The heel came gradually down, and on the 17th, the foot was nearly at a right angle with the leg. A few days later, the foot was as much bent at the ankle-joint as that of the opposite limb. I have been walking about for the last four weeks. I find my limb acquiring both strength and substance, and the condi- tion of the gastrocnemii and other muscles enables me to stand upon the limb, and move it in every natural direction. I may now say, that I am not only free from deformity, but enjoy an ease, freedom, and power in locomotion, such as it was never my lot to enjoy at any previous period of my exist- ence. I consider it a duty I owe to Dr. Little, and to society, to request you will in. sert this concise statement in the next num- ber of THE LANCET. I am, Sir, your most obedient servant, THOMAS INGLIS, M.D. 178, George-street, Glasgow, Oct. 3rd, 1837. PROFESSORSHIP OF ANATOMY IN THE UNIVERSITY OF DUBLIN. ON the point of going to press, we have learned that Dr. Harrison has been chosen to succeed Dr. Macartney in the Professor. ship of Anatomy and Surgery, in the Uni- versity of Dublin. TO CORRESPONDENTS. The writer who has sent to us a request "on behalf of the medical profession" is informed that we have not the means of complying with his request. The applica. tion should be made to Mr. B. direct. We have found it impossible to comply with the request of Dr. G. H. this week. The publication of the letter of Dr. H. Sorley would subject us to an action for libel. Assuredly the Liverpool bladder case does not require another word,. either of explanation or of comment. If, however, Dr. Sorley is desirous of publishing a short exposition of the facts of the case, as they fell under his own observation, free from the objectionable passages contained in his pre- sent communication, we would give it a place in our pages. Still, we are decidedly of opinion that the merits and the demerits of the case have been sufficiently discussed. A Candidate. Sir Wm. Burnett. There is no fee. The letters of lllr. Hedley, Mr. R. Huul, and Amicus Justitiœ, next week. We would insert with pleasure the letter of W. 31. C., did it develop any new views on the subject of medical education. The writer understands the question and treats it properly, but the same sentiments have already often been submitted to public view in the pages of this Journal. The communication of Dr. Hancock has already been printed, we understand, in another form. Mr. DENDY is preparing for publication a work on the diseases of the skin, the ex- ternal signs of disorder, and the constitu- tional peculiarities of children.

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Page 1: TO CORRESPONDENTS

181

CURE OF

CONGENITAL CLUB-FOOTBY

DIVISION OF THE TENDO-ACHILLIS.

THOMAS INGLIS, M.D.

To the Editor of THE LANCET.SIR :—Having observed of late several

cases recorded in THE LANCET, of deformi-ties of the feet, cured by dividing the tendoachillis, I beg leave, in support of that veryuseful and simple operation, to publish myown case.

I labour under contraction of the gas-trocnemii muscles of my right leg from myearliest years. When standing erect, myheel was about an inch and a half from theground ; and when I walked, almost the onlypart of my foot that touched the ground wasthe ball of the little toe. I was obliged touse a stick, and suffered great uneasiness.I went to London, and placed myself underthe care of Dr. Little. This gentleman,whose numerous operations of this naturehave brought the subject of curing thesedeformities, surgically, fully under the noticeof the profession, in your columns, suffered,as you are aware, from the same lameness,and had the operation of dividing the tendoachillis performed upon himself, by Dr.Stromeyer, in Hanover, the true inventor ofthe method, about fifteen months ago. Dr.Little, to whom I beg in this, the most pub-lic way in my power, to offer my gratefulacknowledgements for his kindness and at-tention, while under his care, performed theoperation in his usual skilful manner, on the11th of August last. I sat upon a sofa, oneassistant supported my knee, and anotherheld my foot, and endeavoured to bend theankle as much as possible, so as to renderthe tendon tense, while Dr. Little, restingone knee upon the floor, passed a narrow,curved bistoury across the tendon, betweenit and the deep vessels, nerves, and muscles,from within outwards, about two inches anda half above the os calcis, and divided it in

withdrawing the instrument. As soon asthe tendon was divided, it gave a crack,which was distinctly heard by all thosearound, and the separated ends of it couldbe easily felt with the fingers. The footwas bandaged, and allowed to remain atrest till the 14th, when the small puncturehaving cicatrised, the foot-board was ap-plied to make the necessary extension. Theheel came gradually down, and on the 17th,the foot was nearly at a right angle with theleg. A few days later, the foot was as muchbent at the ankle-joint as that of the oppositelimb. I have been walking about for thelast four weeks. I find my limb acquiringboth strength and substance, and the condi-tion of the gastrocnemii and other musclesenables me to stand upon the limb, and moveit in every natural direction. I may now

say, that I am not only free from deformity,

but enjoy an ease, freedom, and power inlocomotion, such as it was never my lot toenjoy at any previous period of my exist-ence. I consider it a duty I owe to Dr.Little, and to society, to request you will in.sert this concise statement in the next num-ber of THE LANCET. I am, Sir, your mostobedient servant,

THOMAS INGLIS, M.D.178, George-street, Glasgow,

Oct. 3rd, 1837.

PROFESSORSHIP OF ANATOMY IN

THE UNIVERSITY OF DUBLIN.

ON the point of going to press, we havelearned that Dr. Harrison has been chosento succeed Dr. Macartney in the Professor.ship of Anatomy and Surgery, in the Uni-versity of Dublin.

TO CORRESPONDENTS.

The writer who has sent to us a request"on behalf of the medical profession" isinformed that we have not the means ofcomplying with his request. The applica.tion should be made to Mr. B. direct.We have found it impossible to comply

with the request of Dr. G. H. this week.The publication of the letter of Dr. H.

Sorley would subject us to an action forlibel. Assuredly the Liverpool bladdercase does not require another word,. eitherof explanation or of comment. If, however,Dr. Sorley is desirous of publishing a shortexposition of the facts of the case, as theyfell under his own observation, free from theobjectionable passages contained in his pre-sent communication, we would give it a

place in our pages. Still, we are decidedlyof opinion that the merits and the demeritsof the case have been sufficiently discussed.A Candidate. Sir Wm. Burnett. There

is no fee.The letters of lllr. Hedley, Mr. R. Huul,

and Amicus Justitiœ, next week.We would insert with pleasure the letter

of W. 31. C., did it develop any new viewson the subject of medical education. Thewriter understands the question and treats itproperly, but the same sentiments havealready often been submitted to public viewin the pages of this Journal.The communication of Dr. Hancock has

already been printed, we understand, inanother form.Mr. DENDY is preparing for publication a

work on the diseases of the skin, the ex-ternal signs of disorder, and the constitu-tional peculiarities of children.