THE WESTERN JOURNAL OF MEDICINE AND SURGERY. OCTOBER, 1840. ART. I.—An Essay on Tenotomy, with illustrative Cases. By S. B. RICHARDSON, M. D., Lecturer on Anatomy and Surgery, &c., of Louisville, Ky. THE operation of Tenotomy in the treatment of club-foot, which has met with such encouraging success recently in the hands of Stromeyer, of Hanover, and Bouvier and Duval, of Paris, (professed orthopedists of the continent of Europe) must be regarded by all who are familiar with the subject as a beautiful illustration of established physiological and pathological principles, and an undoubted advancement in the treatment of a very extensive but hitherto neglected class of individuals, found in every community. In the legitimate employment of the term, it may be stated in the outset, that tenotomy must be regarded as a discovery, of such extensive application and importance, as to take rank with those great and acknowledged improvements in medical and surgical science, which have shed such brilliant lustre upon all that appertains to medicine, during the present age. Like most true discoveries the merit of its origination cannot be awarded to the labors of a single individual, but it will be found upon a careful inquiry into its history, that the facts which led to its deduction were made known long anterior to designed tendinous section itself. How encouraging should a fact like this be to those who are laboring in the field of observation, and thus become the benefactors of science, it is needless to insist. It rarely, in fact, falls to the lot of any one observer however qualified, to develope a single new principle in any department of knowledge. We are free to assert that every Newton will be found to have had a Gallileo, a Kepler, and other observers as his predecessors, and the remark will be found to apply not less appropriately to medicine than to astronomy and natural philosophy. Science, too, must be regarded, in some sense, as a unit, although artificially divided and sub-divided for convenience of study. It is not in the nature of true knowledge, but in the limited capacity of the human mind, connected with the comparatively brief period allowed for observation, that these artificial arrangements (in too many examples, dismemberments,) have been made and must be allowed to continue. What the God of nature has intimately associated should not in any case, cannot be dissevered except with the most injurious effects. Extra-professional scep ticism among the learned as well as the uninformed is known to exist to some extent every where, in reference to the verity of medicine as a science—with how much truth, let those, who are immediately interested, give the answer, and abate the odium if found in any degree to exist. Some medical men, too, at no very remote date, and who have received the exalted appellation of medical philosophers, are known to have regarded the term science applied to medicine, as an unallowable assumption. By these remarks, we do not wish to be understood as embracing or countenancing the sentiment just referred to; on the contrary we have too much attachment for, and confidence in practical medicine to detract one iota from her just merits, and the noble stand which she has recently assumed, and is destined to occupy (if rightly studied) as an exact science. It must in candor, however, be admitted, that medicine has not kept pace with those sciences par excellence entitled exact. This is doubtless referrable to more causes than onechiefly however to the neglect of the inductive or Baconian (may it not be entitled Hippocratic ?) method of investigation, and the multiplicity of phenomena presented in vital manifestations, coupled with the heretofore almost inextinguishaable thirst for theorizing, and system building, in medicine. The perception of this has led many distinguished physicians of the present age on the continent of Europe and elsewhere, to abandon the false route into which so many have strayed and wasted their energies, and to return to the path of patient observation,-admitting that there is not as yet a sufficient number of well established facts to serve as a basis for a theory, or, more properly, to evolve one or more controlling principles that are to organic what gravitation is to inorganic matter. 1 |