Amputation, an historical sketch : being the subject of the introductory lecture delivered at Netley, in commencing the thirty-first session of the Army Medical School, 1st October, 1875 / by T. Longmore.

  • Longmore, Sir Thomas, 1816-1895.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: Amputation, an historical sketch : being the subject of the introductory lecture delivered at Netley, in commencing the thirty-first session of the Army Medical School, 1st October, 1875 / by T. Longmore. 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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    vented by the ligatures on the vessels, when the screw of the tourniquet was loosened, no fatal loss of blood could occur. The mere operation of removing a limb by amputation was now at last deprived of all its most alarming features. There was no longer the same vital need of performing the amputation hurriedly. Surgeons could now devote attention to considering the most judicious method of performing amputations—the methods which would ensure the most sure and speedy healing of the stumps, and the most serviceable forms of stumps when healed. The account I have laid before you of the method of performing an amputation, and of dressing the stump, which were in vogue when Wiseman’s works were published in the beginning of the last century, will have sufficiently shewn you how many and what serious defects there still remained to be remedied in these pro- ceedings. In the first place, the only mode of amputating was the circular, and this was done by a single straight cut. It is difficult to define the exact period when attempts were first made to remove the inconveniences which this mode of incision gave rise to. Petit, the inventor of the tourniquet, has usually the credit of having first performed a circular amputation by two incisions; the first incision being limited to the skin, and the second being made through the muscles after the skin had retracted, or had been further released and drawn back by the hand of the operator. It is exceedingly likely that Petit was the originator of this plan, for the application of the tourniquet, by leaving the parts near the seat of the division exposed, easily admitted of the improvement being made, while it . could hardly be done when the band was employed in the manner described by previous surgeons. Another French surgeon, Louis, noticing the unequal retraction of the different layers of muscles, has the credit of still further improving upon this plan, by making the first incision divide the skin and superficial muscles, the second incision the deep muscles. Reference to the works of British surgeons, during the latter part of the last and the beginning of the present century, shew that they made great efforts to preserve integuments enough for covering the whole stump; and to assist in this object the rule in circular amputations gradually came to be, after full retrac- tion of the skin, to make as many separate incisions through the muscles as there might be muscular layers. I have not been able to satisfy myself as to who was the , originator of the plan of performing amputation by flaps. Surgeons must have observed and treated accidental injuries in which the only covering for the exposed wound would be a flap. An arm torn from its socket would, probably, leave only such a covering