[73] As an illustration of this rule, I may mention the following
case: A man, during a voyage to a cold climate, had both his feet
frost-bit, in consequence of which mortification ensued. In this state
he continued for two or three weeks, during which he received very
little medical aid. When I saw him, both his feet were mortified,
from the toes to about three inches above the ankle joints, his pulse
was feeble, very frequent, and intermittent, the strength was greatly
impaired, and the countenance sunk and ghastly. The ulcerative action
had been induced for some time, but the want of wine and proper diet
had prevented the system from gaining by the cessation of the local
disease. He began the use of the bark, opium, wine, and soups, which he
took very liberally, in consequence of which his pulse became slower,
and his strength increased. In two days, one of the ankle joints was
removed by clipping through the tendons, and, in a few days more, the
other came away. Amputation was now performed below the knee of the
right leg, the constitution, instead of gaining, rather beginning to
lose ground. The subsequent affection of the system was by no means
great, and, in about a week, he was much stronger; but, as the bones of
the ankle joint of the other leg were carious, he again began to sink.
Amputation was therefore performed on the left side, in about three
weeks after the first. During the cure, the wine, opium, and nourishing
diet, were freely prescribed.
When we do not deem it adviseable to amputate very soon after the
induction of the ulcerative action, it is sometimes useful to cut off
part of the black mortified portion, or perhaps to remove a joint, by
cutting through the remaining ligaments. In this way, we lessen the
fœtor, and make the patient more comfortable.
After making these observations on mortification, I shall conclude with
the following case:
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