Volume 1

The principles of surgery, as they relate to wounds, ulcers and fistulas, etc. Also, a system of surgical operations ... And a series of cases, calculated to illustrate ... the doctrine of tumours, etc / [John Bell].

  • Bell, John, 1763-1820
Date:
1815
Catalogue details

Licence: Public Domain Mark

Credit: The principles of surgery, as they relate to wounds, ulcers and fistulas, etc. Also, a system of surgical operations ... And a series of cases, calculated to illustrate ... the doctrine of tumours, etc / [John Bell]. Source: Wellcome Collection.

    707/732 (page 661)
    OF COMPOUND FRACTURE AND LUXATION, WHEN THE JOINT IS DISTORTED, THE BONES FRACTURED, AND THE INTEGUMENTS LACERATED. It is in the lower extremity only, which bears the whole weight of the body, that we are to look for fuch complication of injury as is defcribed in thefe words; and however a compound fracture of the arm or fore arm may de~ jfroy the part itfelf, life is actually in danger only in great fractures of the lower extremity, which forms fo great a proportion of the whole body. The ancle joint is never diflocated unlefs when the Fibula gives way ; it is never entirely diftort- ed, and the foot turned tranfverfe, without both bones, both Tibia and Fibula being broken ; and when it is entirely diflocated, the integuments are torn at the inner or outer ancle, and often the tibia or the aftragalus are forced through the wound, and the head of the bone on which the body refts quite expofed. If !ofs what to do with this man, who lay not far off complaining of his arm ; I would have cut it off in- ftantly with a razor (for the bone being fhattered, there needed no faw), but the man would not fuffer mg to meddle with his arm, he crying, it was already dreffed. The fight being over, and we got into the next port, I caufed this mariner’s bed to be fet up (which was four pieces of wood nailed together and corded, and a bear’s fkin laid upon it, and fattened between two guns to the carriages); upon this I faw him placed ; and having ordered his arm to be laid fo that I might the better come to drefs it, I fent for dreffings, and laid them orderly upon a fmall pillow well {buff- ed and quilted in the middle. Upon this pillow I firft laid a foft double linen cloth, next to that three li- gatures, then a patteboard wet in vinegar, to make it more foft and pliant; upon that I laid a double cloth, of fuch length and breadth as might ferve to encompafs the fradbured member, which I cut from each end to the middle into three binders. Over the middle of this I placed a fplenium of cloth four double, four fingers in breadth, and of fuch a length as to give ttrength to the fradbure. Over this lay my defenfative fpread upon a thick cloth, of fuch a breadth and length as to take in the whole arm. Dreffings thus laid upon the pillow, I cut off the other from his fradbured arm, and placed the pillow with thefe dreffings ciofe by his fide, fo that I faw his arm laid as I defigned upon my rettridbive, and his hand upon his breaft $ then putting my fingers into his wound, I pulled out firft a piece of a fplinter an inch thick or thereabouts, more or lefs, then rags and bones, great and fmall; I left not the leaft fliiver. When I had fo cleared the wouad of all the extraneous bodies and loofe bones, I was amazed to feel what a void fpace there was be- tween the ends of the bones ; but I proceeded, and cut ofFthe lacerated lips, wffiich were of no ufe, and dreffed up the ends of the bones with a couple of doffils dipped in fpir. vini and mel. ref. warm. The reft of the wound I dreffed as warm with axung. porcin. and mere, praecipat. with fome little ol. terebinth, fpread upon doffils, which I placed lightly within the wound, and upon pledgits without, with an emph diachalcit. malaxed with ol. myrtill. over all the wound then I embrocated the fradbured arm cum ol. myrt. et olivar. immatur. and a little acetum, bringing my rettridbive emplafter, which lay under the arm, over the whole arm, from the arm-pit to the elbow, and ciofe round about, only leaving a fpace to drefs the wound