On gun-shot wounds of the extremities, requiring the different operations of amputation, with their after-treatment: establishing the advantages of amputation on the field of battle. To the delay usually recommended, &c. &c &c., with four explanatory plates / By G. J. Guthrie.

  • Guthrie, G. J. (George James), 1785-1856.
Date:
1815
Catalogue details

Licence: Public Domain Mark

Credit: On gun-shot wounds of the extremities, requiring the different operations of amputation, with their after-treatment: establishing the advantages of amputation on the field of battle. To the delay usually recommended, &c. &c &c., with four explanatory plates / By G. J. Guthrie. Source: Wellcome Collection.

    415/446 (page 377)
    and require amputation : or, both the flexor and ex- tensor tendons are cut across, and hanging’ out of the wound, the joint of the wrist is opened into, and the skin of the hand much torn ; there is also in general considerable heemorrhage, which continues to ooze, although the blood is not thrown out per saltum: The bones are found totally destroyed, and as the hand is frequently bent or closed, the fingers are often also wounded. Amputation is in this case, to be performed as soon as possible, for the sooner the wound becomes a clean incised one, the better. When the metacarpal bones of the three outermost fingers are destroyed, the thumb and fore-finger are worth preserving. The little finger is occasionally to be kept, when the two middle ones are sawed off, and in taking away the two outermost fingers, the next metacarpal bone is not to be removed if it even be a little injur- ed ; the tearing up of the integuments is not of so much consequence as is believed, and in per- forming the operation of removing any two bones, flaps may frequently be procured partly on one side, partly on the other, when a whole one can be ob- tained from neither. The opening into the joint of the carpus, will do well in most instances, if skin can be procured to cover the joint injured : in fact, the hand is so valuable, and is so much under the com- mand of the surgeon, if attention be paid to it at first, that much ought to be hazarded to save it. The removal of the hand is also a last resource, when every attempt has failed.