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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![Concluding RemarJcs.'] may be partly or altogether erroneous. Granted that those which relate to the influence of the blood in these cases,—that those which seek to maintain or even to augment the doctrines of Hunter, —may be fallacious; even if this be so, there still remain a large body of facts which may have their value. The subsequent expe- rience of abler men will ascertain its degree; and the only point on which I am solicitous as regards this matter is, that the experience by which they are tested should be of the same nature, and that when derived from sources where the agency of vitiated air prevails, it should not be too readily allowed to invalidate these statements. I shall make no extended summary, but simply oflier, as fair conclusions, the following remarks. That amputation (especially of the upper extremities) is an operation, per se, little fatal when well performed, when the case is carefully attended to, when no after hsemorrhage or other important contingency affects the result; but that injury or disease will cause a material diff’erence, if they have affected the general system prior to the operation, and in proportion to the degree and mode in which they have done so. That grave injuries do this at the time of their infliction, and independent of any subsequent inflammatory action; although, when this arises, it increases it in a greater or less degree, according to the character of that inflammation and the treatment adopted. They rank first in order in regard to the mortality. That diseases of a particular class,—for example, those w'hich may have recently contaminated the constitution, as acute gangrene (not arising from external injury) or acute suppuration, and long existing ulcers,—will also be the cause of a large share of mortality. ' In other cases of disease, although very severe in themselves, and complicated with such affections of other organs as may eventually cause the death of the patient, yet, the system not being similarly contaminated,* amputation is much less fatal. * The term contamination, although applied with strict propriety to the blood only, is here used to express a change in the system for which I can find no better; and it must not be held as necessarily assuming a change in the blood, although my own opinion is in favour of that view.](https://iiif.wellcomecollection.org/image/b22368462_0044.jp2/full/800%2C/0/default.jpg)
