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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![Diseased Joints.'] ture, other through sound and healthy parts in a healthy person, why should the veins inflame when the cause is an grounds for doubtingtlie hypothesis. This inflam- mation of veins rather to be re- garded as an effect than as a cause; for taking the dififerent cases alleg- ed in proof by various authorities, the inflam- mation of veins in par- turient fe- males, for example. injury so much more frequently than in the unhealthy, when it is disease ? On a careful review of all the phenomena, it appears to me that venous inflammation is rather to be regarded as an effect than the cause. Let us take the case of parturient females, so often advanced in proof of the origin of uterine phlebitis as connected with peculiarity of venous structure. Thousands are delivered every day. The uterine veins are exposed to the local, the mechanical causes of phlebitis, equally whether women are confined in healthy dwellings or in Lying-in Hospitals. Why, in the latter case, do they so often inflame? because, wdth every care taken, the air of the house taints their blood. This is liable to happen if they are visited by persons carrying the emanations from other puerperal cases, or indeed from any kind of erysipelatous inflam- mation, and we must believe that such emanations operate through the medium of the breath on the circulating fluid operatiour*^ generally, and not directly on the uterine veins. Now, put the case of operations, amputation (or any other operation), placed in a similar atmosphere. Venous inflammation, hospital gangrene, &c., are very frequently the results. The claim, then, to explain these various diseased states from an original venous inflammation (excepting where peculiar violence has occurred to the veins,) is hardly well grounded. And if it be allowed to be probable that the shock of a great injury induces a state of the system not precisely the same, yet similar to that w'hich is transmitted from the air, it will follow as a reasonable conclusion, not only that the essential cause of the phlebitis, &c., in the cases first alluded to, is a change in the general system, probably in the blood, from miasmata, introduced through the blood, but that, as regards those which occur after amputations for injuries, disorganization of the blood from shock is an equivalent cause. In ])iu’suing the subject, I may revert to other points (advanced They arc hard- ly the result of tVie veins beinf? open, for this is the case in an immense multi- tude of in- stances where no such conse- quences follow, but seems to be produced by tninted air (un- less where veins have been vio- lently treated,) thus acting through the medium of the blood Venous inilammation being the effect, not the cause, and in cases of amputation for severe injury, an analogous change of the blood the pre- existing condi- tion and cause.](https://iiif.wellcomecollection.org/image/b22368462_0014.jp2/full/800%2C/0/default.jpg)
