On the causes of mortality after amputation of the limbs. Pt. II. Diseases / by J.H. James.
- John James
- Date:
- 1850
Licence: Public Domain Mark
Credit: On the causes of mortality after amputation of the limbs. Pt. II. Diseases / by J.H. James. 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 mortality from the opera- tion itself is in these cases so small as to show how little pro- hahle it is that the great amount • after amputation for injuriet arises from the opera- tion, but ra- 'ther from cer- tain effects of the injury, hitherto little recognized, and erroneously im- puted to iiidam- mation of the veins of the part, especially in its bony Btrocture. 8 ON THE CAUSES OF MORTALITY Diseased Joints.'] When speaking of the amputations for injuries, the causes of mortality were considered, first, as arising from the effects of immediate shock; and, secondly, from secondary processes; the latter also being explained in chief measure from the more remote influence of shock {vide “Transactions” of Provincial Medical and Surgical Association, vol. xvii., p. 64 et seq.) This opinion was then supported by the phenomena of that series only, and it is founded on views widely different from those of men of the highest rank in the profession, many of whom have lately imputed them to venous inflammation originating in the part, especially in the hone, and the subsequent admission of pus into the circulation. A review of the present series enable me to examine the question more closely. Looking at the cases from injury, of 13 primary amputations of the thigh, 8 died (vol. xvii., p. 52; table also, p. 59); of these, four proceeded from phlebitis and secondary inflammation. After 62 thigh amputations for diseased joints, two; one from secon- dary inflammation of the brain; one from exhaustion and gangrene. Again, of 18 amputations of the leg for injury, seven died; five from phlebitis and secondary conse- quences. After 32 leg amputations for diseased joints, two only (No. 120, from irritative fever; No. 288, from hsematemesis.) Placing them in a tabular form, they will stand thus:— Compara- tive state- ment of mortality after ampu- tation for injuries with that for dis- eased joints Table III. Amputations for Injury. For Joint Diseases. 1 Thigh (primary) Leg „ Cases. Died. secondary processes* 13 . 8 . 4 18 . 7 . 5 1 1 Thigh i Leg . ! Cases. Died. 62 . 2 32 . 2 31 . 15 . 9 94 . 4 Subtracting the deaths from immediate shock in the list for injury, the proportion is as 31.9, from phlebitis and secondary processes; allowing all the cases after amputation for diseased](https://iiif.wellcomecollection.org/image/b22368462_0012.jp2/full/800%2C/0/default.jpg)
