Statistics of secondary haemorrhage after amputation : with statistics of amputations at Guy's Hospital for forty-two years / by John Poland.

  • Poland, John, 1855-1937
Date:
[1887]
Catalogue details

Licence: Public Domain Mark

Credit: Statistics of secondary haemorrhage after amputation : with statistics of amputations at Guy's Hospital for forty-two years / by John Poland. 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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    was reported as dying from purpura and blood-oozing. These cases extended over a period of eleven years, from January, 1853, to October, 1863. The following figures showed the results of amputations at St. Bartholomew's Hospital from January 1st, 1869, to January 1st, 1870. Total number of cases 46. Total number of deaths 7, or 1 in every 65 died, or 15'2 in every 100. No cases of secondary haemorrhage. Adding to the first-named 358 cases the amputations referred to below, and which had been treated since October, 1863, he had 480 operations with 6 deaths from secondary haemor- rhage, or 1 in 80, or 12 in 100. In the personal experience of Mr. Paget and Mr. Callender, only twice had secondary bleeding occurred out of 108 cases. Of the 2 cases, in 1 it was predicted on account of the excessively tight application of the ligature. The ligature cut through the femoral artery and there was severe bleeding on the fifth day. In the second case the patient recovered after ligature of the common femoral. He therefore considered himself justified in stating that secondary bleeding was a comparatively rare occurrence after tying main arteries. Such figures as these, taken from one surgeon's practice, and ranging over so short a period, cannot but be misleading. In the practice of the whole surgical staff of Guy's Hospital during the two years 1878, 1879 there were no cases of secondary haemorrhage, either fatal, severe, or slight. Now, in all the figures just quoted, and in those of which the writer has been able to avail himself, no calculation, and but a passing mention, is made of cases of secondary hasmorrhage from amputation wounds, which are treated and ultimately recover. Yet it cannot be doubted that these too in their clinical aspect should be taken into consideration if we wish to trace its causation. It is true, as will be seen by the Tables accompanying this paper, that death from secondary haemorrhage is of the greatest rarity at the present time, and unquestionably this diminution in frequency is largely due to the advances gained in the antiseptic treatment of wounds. Thus, out of the 641 amputations during the ten years 1877 —1886, there were 6 in which death resulted from this cause, but absolutely 5, for in one, although this took place from exhaustion and suppuration four months after VOL. XLV. 16 I
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