A summary of the results recorded in a series of lectures ... on the nature, progress, and treatment of complicated injuries of the extremities, and on amputation and its effects in civil and military practice / [Sir Rutherford Alcock].

Rutherford Alcock

Date:: 1841

Credit: A summary of the results recorded in a series of lectures ... on the nature, progress, and treatment of complicated injuries of the extremities, and on amputation and its effects in civil and military practice / [Sir Rutherford Alcock]. Source: Wellcome Collection.

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$resemblance and differences, thus x*endered gross and palpable. Statistics may better be illustrated by reference to the mani¬ pulations of a scientific chemist, ten thousand fractional parts aggregated into one, gives a mass sufficiently large to produce appreciable and definite results in the crucible, each of which, from their larger proportions, can be submitted to various tests, until their real nature is determined with precision and with the utmost certainty: whereas the same process by no art can be successfully applied to an unit, or a grain’s weight, still less can any intermediary result be tested and ana¬ lysed in various ways, under different con¬ ditions and influences, until a conviction of truth and accuracy in one fixed product is obtained. In this spirit, upon these grounds and on this principle, should statistics be applied to medicine ; and thus applied and understood, i they form a means of advancing science, yielding in none, hitherto applied in efficiency, value, and importance. Neither certainly can 1 they boast of any exemption from labour: they are not to be approached carelessly, or to be taken up by snatches, and again laid down. To elaborate a series of conclusions on which general principles may be con- I structed, requires long and patient efforts to > collect facts, which form the minute particles { to be aggregated. To form a sufficient mass for the crucible, they must be faithfully observed I and discriminated, otherwise fragments of different materials are added to the matter ] to be tested, and falsify the whole of the 5 results. The facts are, so many grains of t1 gold, each requiring the same care and dis- i crimination in its collection and elimination • from all earthy or extraneous matter in con- ' nection, which may often bear some analogy, i and yet be essentially different in character 1 and properties. When these separate parts 3 or particles, by a continued series of efforts, I amount in the aggregate to a sufficient mass ( to admit of analysis, the results must be sub- i mitted to various tests, by modifying the cir- j cumstances, by the combination of various : other elements, &c. This process in itself is : one requiring the utmost care and conscien- o tiousness, otherwise, however carefully se¬ lected may have been the materials, the re- i suits may be full of error. I have here given you a description of [i my own task, and of the various steps of the inquiry we have prosecuted to- >£ gether; the conclusions I have laid before ( you were none of them foregone : I placed the materials I had been years in collecting J into the crucible before you, analysed them ■ even to their last elements, and then declared to you the legitimate results. To thus sub¬ mit materials to this process, it was impera- ■ tive that I should myself have collected them, not that others might not have performed this part better and more amply, but that no such It facts, in complete series, with all their va¬ rious characters and conditions, essential to their classification and analysis, existed in the records of surgery, without the aid of which 1 must necessarily have abandoned the enterprise. 1 might, however, have given you, like the scientific chemist, the mere results in the last combination and the most concentrated form. My first idea was to do this, shrinking from the possibility of wearying with a detail of the whole of the processes by which they were elaborated, and the tests and materials em¬ ployed. But when the chemist wishes to in¬ troduce any new combination of elements, from which he derives a result differing in some properties from any others previously admitted in the laboratory, he feels it is not sufficient to state the fact that he has ob¬ tained a result, but he details the elements employed, the analysis by which he proves them to be those, and no others ; the combina¬ tions they assumed, and the various tests to which he subjected them, and under what conditions of temperature or external relations, generally, such tests were applied; that all might judge, and not he alone, whether these were capable of bringing new influences to bear, not contemplated by the manipulator, and consequently giving admission to sources of fallacy in the results. Moreover, if the whole process be delicate, complicated, highly susceptible of sources of fallacy, re¬ quiring an aggregate mass of material diffi¬ cult for any single individual to collect, before the result can be fully established, and take its place among the fixed products, it is highly desirable that it should be made public, that it may be elaborated by others elsewhere, with the united aid of many, ta produce a mass of evidence sufficiently large to inspire confidence, and indeed a certain conviction of the accuracy of any result ob¬ tained, from such an aggregate of material, by competent inquirers. Influenced by these considerations, I have' gone through the whole of the process with the mass in my hands, not so large as I could wish, but collected and sifted with great care. If any one doubt the accuracy of the results, the competency of the pro¬ cesses, or of the amount of the mass subjected to the crucible, and all are open to discussion, I shall hail with great pleasure the efforts of others to attain the same end I have in view. I shall rejoice in those efforts, assured that truth will be obtained, and that fixed principles of practice, in reference to the more important operations of surgery, will supply the place of loose conclusions, based upon erroneous premises ; and that the pre¬ sent rules of practice which, whether they may prove right or wrong, are at all events founded upon imperfect analogies; general impressions of imperfectly-recorded and often contradictory experience; and nume¬ rical results, either too small in number, or when large, without the necessary guaraa-$