On acupressure in amputations : with illustrative cases / by J.Y. Simpson.

  • Simpson, James Young, 1811-1870.
Date:
[1860]
Catalogue details

Licence: Public Domain Mark

Credit: On acupressure in amputations : with illustrative cases / by J.Y. Simpson. Source: Wellcome Collection.

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    as yet universally practised among surgeons residing in the more distant counties of our kingdom/’ * In some semi-rude countries and com¬ munities, caustics are still the only haemostatics employed after amputations. A few years ago my friend, Dr. Arthur Mitchell, when in Algeria, passed some time as a guest with a powerful Sheik in the Sahara. His host, who had been an officer of high rank in the army of Abd-el-Kadir, had his leg shattered by a French cannon-ball, and it was subsequently amputated by the surgeons of his country at the knee-joint. They stemmed the haemorrhage by applying hot pitch to the raw surface of the wound; and the stump itself was, as Dr. Mitchell assures me, an excellent and useful one. If some correspondent of the Times, writing at the present hour from the camp of the army of Morocco, were to inform the English readers, professional and non-professional, that the African surgeons there, after amputating the damaged limbs of the soldiers wounded at Tetuan, deliberately placed five or six seton-threads between the sur¬ faces of the flaps, and systematically attached and anchored these several seton-threads to little strangled pieces of flesh in the depths of the wounds, necessitating the seton-threads slowly to ulcerate, suppurate, and mortify through the points to which they were fixed before they were allowed to escape or be detached,—perhaps many would, at first sight, deem such strange practices as characteristic of the “barbarous Moor.” Yet, after all, this is only and truly what the enlightened Surgeons of modern Europe do, when they stanch the haemorrhages after amputations by tying silken ligatures around the drawn-out and isolated ends of the bleeding arteries. For, assuredly, these silken ligatures, with the imbibed dead, and some¬ times morbid, animal fluids decomposing in them, speedily and certainly become small irritating setons along the whole course of their tracks; and as is known to every practical surgeon, and as has been especially pointed out by Bell, Crosse, Brodie, Pecot, Velpeau, Wise, and others, the portion of every artery strangled by the ligature ultimately sloughs off, and generally comes away in the loop of the ligature itself. Thus the author of the latest work pub¬ lished on surgery in the English language, namely, Professor Gross, of Philadelphia, when treating of this subject observes :—“ The process by which the separation of the ligature is effected is worthy of inquiry. It is generally ascribed to ulcerative action, and this is undoubtedly true ; but it is equally true that that portion of the artery immediately embraced by the ligature mortifies, and comes away in the form of a slough.’ f Union by the first intention of the flaps of a stump after ampu¬ tation is certainly an object worthy of being aimed at by all possible means, more especially as the operation of amputation is usually performed in persons who have their constitutions damaged and shattered by previous disease or injury, and who are hence little * Erichsen’s Surgery, p. 141. t System of Surgery, 1859, vol. i., p. 810.