A dissertation on the inutility of the amputation of limbsBilguer, Johann Ulrich
History
A dissertation on the inutility of the amputation of limbs
Bilguer, Johann Ulrich
Amputation -- Early works to 1800
When a patient is brought to our military hospitals, who has had his
foot, leg, hand or arm shattered by a ball, or any other violent cause,
whether the parts are intirely carried off, or adhere by a little
flesh and skin, but in such a manner that there is not any hope of a
re-union; in this last case, we begin by cutting through these slender
attachments which keep the part suspended, and thus intirely separate
it from the body. In both cases, when pieces of the extremities of the
bones jut out, and may prove hurtful, they must be sawed off with a
convenient saw, whether they be moveable or still firmly adhere to the
limb: When they are moveable, they must be held by an assistant. I hope
no man in this treatment, will pretend to see any thing like what is
properly called amputation, which I condemn.
After this first operation, I carefully examine if there be still any
small splinters left, and whether they are only held by the fleshy
parts, or still adhere to the bone; I remove all those, with the
fingers, or with instruments, that can be separated without violence
or a fresh effusion of blood.
After removing as many splinters as I can, I slightly compress the limb
between my hands, gently stroking it lengthways, from above downwards,
endeavouring, at the same time, to restore, as much as possible, its
natural shape; I dress the sore with a digestive, to which I add a
little essence of myrrh, or solution of mastic: I cover the whole with
dry lint; applying the same bandage as after artificial amputation,
sufficiently tight, without, however, running the risque of causing
pain or increasing the inflammation: Afterwards I moisten the whole
with as much spirit of wine as may penetrate to the parts affected;
taking care to keep the limb extended in a right line, and laid soft.
The first days, till the suppuration becomes plentiful, I only dress
it once every twenty-four hours, sometimes seldomer; but when the
suppuration is begun, I renew the dressings twice a day; and such of
them as immediately touch the bone, or fleshy parts of the wound, I
cover with lint dipt in solution of mastic, balsam of Fioraventi, or
some other balsamic essence, in order, by that means, to prevent too
large a suppuration. I likewise remove, each dressing, all the little
shivers of bone which do not reunite, and which, though they could not
be separated at the first dressing, may in the succeeding ones.
Public-domain text, read in full here on John Shaqi.
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