Remarks on amputation : an essay, submitted to the Faculty of Physicians and Surgeons of Glasgow, when candidate for admission into that body / by Alexander King.

Date:
1842
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on amputation : an essay, submitted to the Faculty of Physicians and Surgeons of Glasgow, when candidate for admission into that body / by Alexander King. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    dition, and frequently before that is accomplished, phlebitis manifests its presence, and the patient's doom may be said to be sealed. The simpler and lighter the dressings the more favourable the result of the case. I have been in the habit of bringing the incised surfaces together, and keeping them in that state by two or three stitches, assisted by a narrow strap of plaster between each. Care is taken that sufficient openings are left for the escape of pus, &c. between each stitch and plaster. Over the line of incision is applied a piece of lint spread with soft ointment. An equable pressure is kept up over the whole limb by the application of a bandage, commencing from above, and carried downwards by circular folds to nearly the edges of the incision, but avoiding the front of the stump, in case of retarding the escape of matter. The limb is then placed on a pillow, on a level with the body, with one edge of the wound slightly depressed, and covered in such a manner as may best suit the season of the year. This simple method of dressing the stump appears to have many advantages. The lint can be removed at any time, and the state of the cut surfaces accurately ascertained. If any of the stitches or straps of plaster cause irritation they can be cut across with the scissors; and if too much action be going on in the stump, it may be moderated by proper local applications. If matter be formed in the interior of the stump, its escape may be facilitated through the ligature openings by gently moving and separating these bodies; and the straps of plaster may be removed and replaced at any period after the operation, one by one, as may be found needful, thus rendering a formal first dressing, (sometimes as formidable to the patient as the operation itself) at a given period, altogether unneces- sary. The practice of covering up the face of a stump, by plasters, ointments, &c. &c. which even at the present day is so common, and removing the whole at any period between the third and the sixth day, washing the surface, and reapplying a similar quantity of fresh dressings, is, in my opinion, very bad surgery—alike opposed to the dictates of common sense, and the principles of sound physiology. The Surgeon, who keeps the face of a stump covered with heavy complicated bandages and dressings, for several days subsequent to the operation, virtually commits the cure to chance during the most important period. A reaction, which at first might have been moderated, or subdued, by the early application of cold cloths, or by
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