Virginia Argus. [volume] (Richmond, Va.) 1796-1816, 1804-04-28

NE OOJeCt OF tne ioiiowihS quotations.
: from the last edition of Bells Surge
ry, volume 9TH, will be understood apply
ing TO the case annexed.
On the propriety of amputating in com
pound fractures, page SIS. In the course
of my own experience, do not recolleGt
! an instance of death having ensued from
the operation alone, where the disease was
Of some duration, where it was advised,
and it has often been performed where
! the patient was greatly exhausted, where
as many have died merely from the ope-
ration where il has been put in practice
soon after the accident"-page 24O-(on
. amputation)- unless the operation can
! be performed Immediately after the acct
dent, it cannot again be admissible for
considerable time, for whenever limb has
become swelled and nAamu d, il can never
but with the utmost danger, be taken off
till these symptoms subside"-again, on
notification, page $40" The skin may
be perfectly sound and may be free from
pam, inflammation and swelling, and yet
the deep seated muscles and other parts
contiguous to the bone in state Of gan
grend." OF this have seen various in.
stances-but even where the whole diyid-
ed parts are found to be entirely sound, IS
the operation is performed while NORTH
cation is advancing, the disease seldom
tlIis OF Selling The stump--at least never
knew an instance To the contrary and
have unfortunately been concerned in diff
iereAt cases where this practice was adopt
cd"-aga,n, page 25i--"I would consi-
der II as sufficient 10 wait till the NORTH
cation was completely stopped, but not
much longer"
The case OF I'd W-d. aged between
thirty and forty, on the 9TH January. He
accidentally received load Of shot through
the upper part of his right arrn--,he loss
otbonc and muscular substance rendered. II
necessary to take of the limb in the Joint
OF the shoulder-thc patient would not adj
NIT IL, neither was the operation advisa-
ole from the spasms, lerkings, swelling
and inflammation which occurred almsst
Immediately after the accident--not With
| standing the most approved treatment,
these symptoms were on the fourth day
succeeded by a deep and extensive NOR
! tifica;ion reaching above the shoulder.-
! He Immediately began and continued the
peruvian bark, by taking two tea spoon
with bark poullices, sprinkIed with G..
Myrrh, everj six hours, though we dimi-
nished the quantity given and applied
Yet we did not quit the use of the bark till
| the . d, when Doctor Z. of BuckLacham
and DR.. L-g-n, of Warren uat4r,ooA 10
| operate in the shoulder loint-Ever since
the year 1901, when | quit all pretensions
to- surgical operation. DR.. Morrison as was
! perfectly understood, and was to aid {when
coyenient) in my stead, as he lived with
in mile of this patien, He accordingly
acted in the operation, which was perform
ed on the 9Th January, 1904. How soon
we may take off a limb with safety after
modification has ceased, has never been
decided-In this case the appearance in
the skin had ceased on the 22d. Instead
of sanies or thin discharge from the
wound, 1t was to appearance lolerable mat
ter and the wound Showed growth of
flesh. Notwithstanding, the operator
! Doctor p. showed the modification very
! plainly, Ito tue spe6lators) was still in the
muscular substance round the socket Of
the loint where the head of the shout
der was lodged, Doctor Logan and Doc
! tor Morrison no doubt examined then, and
on the succeeding dressings Though
his case does not absolutely FIX q critic
I rIon to Judge of the precise period for o.
I peraling after mortihcaton has elapsed,
yet a. It throws light on the subject, in
stead Of sending it the New York Medical
Repo-i DRY as was originally intended
please insert it in your Argus.
l.. MIEAN.
The foregoing statement is correct
the spasms. swaline and inflammation,
and modification, come on ~ such rapid
succession; hat no room interviewed to
amputste. The operator Doe. Pcs eson,
Showed the remains e the modification
in the stump, and showed the remains
Of the modification m the first dressing.
ROBERT LOGAN.
February, 1909.
J In the foregoing case, the remainder Of
: modification continued to the third dress