The proper period for the performance of amputation in cases of traumatic injuries / by B.A. Watson.

  • Watson, B. A. (Beriah André), 1836-1892.
Date:
[1880]
Catalogue details

Licence: Public Domain Mark

Credit: The proper period for the performance of amputation in cases of traumatic injuries / by B.A. Watson. 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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    the patient to so low a state, and subjects the blood and juices to such an alteration, as must unavoidably render the subsequent operation, if not entirely unsuccessful, at least exceedingly dubious.” The French Academy of Surgery proposed this question as the subject for a prize essay in 1755, and again in 1756. This discussion was participated in by Faure, Leconte and Boucher. The Academy awarded the prize to Faure, and have, therefore, been accused of de- ciding in favor of delaying the operation whenever practi- cable, although from tlie first it were absolutely necessary. This accusation is however shown to be unjust by the ex- ceptions noted in Faure’s paper. Faure thought that an amputation performed immediate- ly or very soon after the receipt of an injury would be dan- gerous, because nature seems to demand that an operation of this importance, which produces so much disturbance of the natural function of the animal economy should never be done during the period of the most violent agitation, and while the patient is in the highest state of bodily excite- ment. He admits only of exceptions in the following cases : I. When the limb has been torn from the body. 2. When a comminuted fracture involves a large articulation, whether caused by gunshot wound or otherwise. 3. When an ex- tremity is almost destroyed, the bone being extensively comminuted, with considerable loss of the soft parts. 4. When the bones are extensively comminuted and the ad- jacent tissues are injured and contused, with destruction of the tendinous and aponeurotic structures. 5. If a fracture involves an articulation even in the slightest degree with a considerable destruction of the ligaments of the joint, haem- orrhage from an arterial trunk of an extremity which en- dangers the safety of the patient and cannot be controlled except by amputation. Leconte, a physician of Acueil, advocated the same ideas in his memoir which received an honorable mention, and was published in the collection of prize essays by the Acad- emy of Surgery. Boucher argued in favor of immediate amputation, and justly claimed that delaying an amputation made necessary