The proper period for the performance of amputation in cases of traumatic injuries / by B.A. Watson.

  • Watson, B. A. (Beriah André), 1836-1892.
Date:
[1880]
Catalogue details

Licence: Public Domain Mark

Credit: The proper period for the performance of amputation in cases of traumatic injuries / by B.A. Watson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ing of our troops in Portugal, the propriety of the practice was impressed upon the surgeons, as I have been informed by Mr. Gunning, then senior surgeon upon the staff, and sub- seqently surgeon-in-chief of the Peninsular army ; the prac- tice was constantly followed, and the precept orally deliv- ered from surgeon to surgeon during the whole period that I served in that country, and the able work of Mr. Guthrie forcibly elucidates its propriety ; while the utility of the same practice, as adopted by the French, is fully shown by M. Larrey. Finally, the results of the field amputations after the battle of Waterloo, confirm the published experience of both these writers, and it is to be hoped that the question is now set at rest forever.” These views were not shared by Mr. Hunter, who in writ- ing on this subject remarks:* “Nothing can be more im- proper than this practice,” and he proceeds to assign his reasons which have long since been shown to be fallacious. The opinion here expressed by this distinguished surgeon had very little influence on military surgeons, and they merely deigned to answer by asserting that civil surgeons were not in such a position as to enable them to form a cor- rect opinion of the advantages of primary amputations. Erichsen says : + “ In military practice, secondary amputa- tion is, in general, more fatal than primary. Thus, Faure saved only 30 out of 300 secondary amputations, whilst Larrey saved three-fourths of those in which he amputated primarily. In the Peninsular war, the mortality after sec- ondary amputation of the upper extremity was twelve times, and after secondary amputation of the lower limb, three times, as great as after primary amputation of these parts. In the British army in the Crimea, from the 1st of April to the close of the war, the relative rates of mortality per cent, after primary and secondary amputations was as follows :—after primary amputations at the shoulder, 26 ; of the arm, 17 ; of the fore-arm, 3 ; of the thigh, 62 ; of the leg, 30 ; and of the foot, 17 ; after secondary amputations at the shoulder, 66 ; of the arm, 31 ; of the fore-arm, 28 ; of the thigh, 80 ; and * On the Blood, Inflammation and Gunshot Wounds, Phila., 1841, p. 538- f Science and Art of Surgery. Seventh Araer. Ed. Vol. I, p. 83.