The double-flap and circular amputations contrasted : being an abstract of a first prize essay at the University of Edinburgh / by F.N. MacHardy.

  • MacHardy, F.N.
Date:
1841
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Licence: Public Domain Mark

Credit: The double-flap and circular amputations contrasted : being an abstract of a first prize essay at the University of Edinburgh / by F.N. MacHardy. 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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    Messrs Syrae, (1) and Dowel, (2) Dr Young, (3) and several Pari- sian surgeons, (4) to be epidemic ; Mr Druitt, (5) epidemic and infectious; and Dr Wells, (6) infectious and contagious. Of these theories, * * the latter, based on extensive observation, appears to be the most rational, but, as yet, sufficient proof has not been ad- duced that this malady is also epidemic. Mr Travers (7) has attributed tightness and the irritation caused by suppurating surfaces to be a frequent cause of this affection, and although theoretically the flap should be more ex- empted than the circular incision, still, practically, it appears that a common liability extends to both. 6th, Gangrene.—Gangrene, which M. Corbin (8) of Hopital La Charite, finds frequently complicated with phlegmonous erysipelas, has been ably investigated by John Bell, Rollo, Thomson, Blackadder, (9) Boggie, Sir Gilbert Blane, (10) Trot- ter, (11) and Carswell. (12) Gangrene, as the cattse of amputation, may be spontaneous or traumatic. In either, it is essential to know when and where to (1) Oral. Clin. Lectures. (2) Dublin Journal of Med. Science. Nov. 17, 1834. (3) Glas. Med. Jour. 1829, v. 2, p. 247. (4) Lancette Fran9aise, 1831. (5^ Surg. 1839, p. 196. (6) Trans, for improv. of Med. Chir. knowledge, v. 2. (7) Const, irrit. 1835, V. 2, p. 127. (8) Clin. Hop. La Charite, 1835. (9) Pha- gedaena Gangrenosa. (10) Diseases of seamen. (11) Medica Nautica. (12) Forms and illus. of disease. * Dr Williams (on Cut. diseases) remarks, that if a person be inoculated with the fluid contained in the phlytsense of genuine erysipelas, a swelling characteristic of that from which it was derived is produced; also, in twenty-one cases on board the ship Jalouse, the majority took erysipelas from direct personal contact, (Lond. Med. and Phys. Jour. 1814, v. 31, p. 451.) 2dly, Dr Wells observes, that the miasmata of erysipelas may extend from the patient with marked intensity to a greater range than in typhus; and Ralph Cumming has made similar observations. Again, the new buildings of St Thomas’s being commenced, before the old, in which this affection prevailed to a great extent, was demolished, the symptoms again appeared, from which it may be inferred, that the erysipelatous poisonous effluvia con- taminates the structure, from which the disease may be propa- gated with more or less intensity, according to the seasons and variations of temperature.