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Updated: May 11, 2025
In this affection the colored sweating appears symmetrically in various parts of the body, the parts commonly affected being the cheeks, forehead, side of the nose, whole face, chest, abdomen, backs of the hands, finger-tips, and the flexors, flexures at the axillae, groins, and popliteal spaces. Although the color is generally black, nearly every color has been recorded.
These persons can completely straddle two chairs, and do what they call "the split;" they can place their foot about their neck while maintaining the upright position; they can bend almost double at the waist in such a manner that the back of the head will touch the calves, while the legs are perpendicular with the ground; they can bring the popliteal region over their shoulders and in this position walk on their hands; they can put themselves in a narrow barrel; eat with a fork attached to a heel while standing on their hands, and perform divers other remarkable and almost incredible feats.
The patient upon whom he performed his now celebrated operation was afflicted with a popliteal aneurism that is, the aneurism was located on the large popliteal artery just behind the knee-joint. Hunter, therefore, tied off the femoral, or main supplying artery in the thigh, a little distance above the aneurism.
The limb having been rendered bloodless, existing sinuses are enlarged, but if these are inconveniently situated for example, in the centre of the popliteal space in necrosis of the femoral trigone it is better to make a fresh wound down to the bone on that aspect of the limb which affords best access, and which entails the least injury of the soft parts.
The child was picked up unconscious, with its thigh entirely severed, and the bone broken off about the middle third; about three inches higher the muscles were torn from the sheaths and appeared as if cut with a knife. The great sciatic nerve was found hanging 15 inches from the stump, having given way from its division in the popliteal space. The child died in twelve hours.
The Hunterian operation ensures that the ligature is applied to a part of the artery that is presumably healthy and where relations are undisturbed by the proximity of the sac; the best example is the ligation of the superficial femoral artery in Scarpa's triangle or in Hunter's canal for popliteal aneurysm; it is on record that Syme performed this operation with cure of the aneurysm on thirty-nine occasions.
Gerard reports recovery from a case of sclerema neonatorum in an infant five weeks old, which seemed in perfect health but for this skin-affection. The back presented a remarkable induration which involved the entire dorsal aspect, including the deltoid regions, the upper arms, the buttocks, and the thighs, down to and involving the popliteal spaces.
He has done all in his, power to make his limited supplies meet the enormous demands. At this hospital Major Wood kindly invited me to perform an amputation of the thigh for gangrene caused by a gunshot injury which had fractured the lower portion of the femur, and cut the popliteal artery.
When the femoral below the origin of its deep branch or the popliteal artery is obstructed, the veins remaining pervious, the anastomosis through the profunda is sufficient to maintain the vascular supply, and gangrene does not necessarily follow. The rupture of a popliteal aneurysm, however, by compressing the vein and the articular branches, usually determines gangrene.
Of the numerous bursæ in the popliteal space, that between the semi-membranosus and the medial head of the gastrocnemius is most frequently the seat of disease, which is usually of the nature of a simple hydrops, forming a fluctuating egg-or sausage-shaped swelling at the medial side of the popliteal space. It is flaccid in the flexed, and tense in the extended position.
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