Surgical cases / by John Campbell.

  • Campbell, John
Date:
1832
Catalogue details

Licence: Public Domain Mark

Credit: Surgical cases / by John Campbell. Source: Wellcome Collection.

    6/16 (page 4)
    however, proved tedious, owing chiefly to the formation of a succession of small abscesses in the stump, w’hich did not become firm and properly consolidated until between three and four months after the operation. T met the patient, many months afterwards, in good health, walking with the assistance of an ar¬ tificial leg. Observations.—Amputation of an extremity during the con¬ tinuance of a spreading gangrene, and before a line of separa¬ tion has taken place between the dead parts and the living, is a practice which was at one time condemned almost universal¬ ly by surgical writers ; nor was it until a comparatively late pe¬ riod tliat the propriety of the rule laid down upon this subject came to be called in question. When we consider, indeed, that the doctrine alluded to has been supported and enforced by men of the first eminence in the profession, amongst whom it is suf¬ ficient to mention the names of Sharpe, Pott, and Richter, it is not surprising that few felt disposed to deviate from a rule which had received the sanction of such high surgical authori¬ ty. But this maxim or dogma, so long taught as an acknow¬ ledged principle in the schools, and assented to by practition¬ ers as of universal application, has in the course of more ex¬ tended observation and experience, undergone certain modifica¬ tions, and has been shown to admit of some exceptions. Lar- rcy pointed out the important practical distinction (as affecting or determining the question of amputation) between traumatic gangrene and that arising from constitutional causes ; and a si¬ milar principle has been recognized by other writers of deserv¬ ed reputation, who have likewise sanctioned the removal of a limb in cases of mortification arising from external or mechani¬ cal causes, before nature has set limits to the progress of the disease by any visible line of demarcation It may be suppos¬ ed that the examples of success already published by Larrey, Hutchison, Lawrence, and others, * are sufficient to establish fully the propriety of the practice now mentioned ; but, as the instances of a fortunate result are not very numerous, I have thought that another well-marked case terminating favourably under circumstances apparently not very promising, might prove worthy of being recorded. Amputation in the present case was not resorted to until na¬ ture seemed unable to resist the farther progress of the disease, by throwing off’ the diseased parts; while, on the other hand, * Amongst those who deserve to be ranked as the earliest advocates for the prac¬ tice of amputating in cases of traumatic gangrene, before a line of separation has taken place, I ought to mention Mr Curtis, a naval surgeon, who appears to have curried the practice into effect at iMadras in 1 7ff2.—See Clinical Lectures by Sir Ceorge Balhngall, 11128, p. 8.