Memoirs of John Abernethy: With a View of His Lectures, His Writings, and Character; with Additional Extracts from Original Documents, Now First PublishedMacilwain, George
Science
Memoirs of John Abernethy: With a View of His Lectures, His Writings, and Character; with Additional Extracts from Original Documents, Now First Published
Macilwain, George
Abernethy, John, 1764-1831; Physicians -- Great Britain -- Biography
He always felt a great deal of interest about compound dislocations of
the ankle-joint; because of his conviction that amputation, then so
commonly resorted to, was unnecessary. He used to tell several cases in
his lectures. One of them we will briefly relate here. It was that of a
labouring man, who fell off a scaffold in his own neighbourhood; and,
amongst other surgeons, they had sent for Abernethy. When he got to
the house, he found, he says, "a poor wee man, lying on his mattress,
with a very complete compound dislocation of the ankle-joint. The joint
was completely exposed, and the torn skin was overlapping the edge of
the bone." He placed the parts in their natural position, and drew the
skin out of the rent; and when he had thus adjusted it, as he said, a
horrible accident looked as if there had been very little the matter.
"Do you think, sir," said the poor little man, "that this can ever get
well?" "Yes, verily," said Abernethy. "Do not be out of heart about
it; I have known many such cases do well." "Why, sir," said the man,
"they have gone for the instruments." "I now found," said Abernethy,
"that two other surgeons had seen him, and had determined that it was
necessary to amputate. I felt that I had got into an embarrassing
predicament, and was obliged to wait until these heroes returned. When
they arrived, and saw the man lying so comfortably, they seemed a
little staggered: but one of them said, 'Mr. Abernethy, you know the
serious nature of these accidents, and can you give us an assurance
that this will do well?' I said, 'no, certainly not; but if it does
not do well, you can have recourse to amputation afterwards, and my
surgical character is pledged no further than this. I give you the
assurance that no immediate mischief will come on to endanger the man's
life. You may wait and see whether his constitution will allow him to
do well.' I added: 'I feel that I am got rather into a scrape; so you
must allow me to manage it in my own way.' So I got splints, put up
the limb, varnished the plaister, and then told them about sponging
it continually, so as never to allow any increase of temperature. Now
there are two holds you have on a patient's mind—hope and fear; and
I make use of both. So I said, 'If you lie perfectly still, you will
do well; and if you move one jot, you will do ill—that's all.'" The
remainder of the case need not be given. The man recovered, and saved
his limb.
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