Memphis daily appeal. [volume] (Memphis, Tenn.) 1847-1886, 1862-07-19

wounded fnot torn aercss), the bone being un-
injured the sufferer will probably bleed to death,
unless aid be afforded, by msking compression
above, and on the bleeding part. \ long, but
not broad stone, tied sharply on with banker
/ chief will often suffice until assls tanee can ne
obtained when both ends OF the DIVIDED OF
wounded artery are to be secured by yligatures.
q %. Tire uoper eud of the great artery of the
thigh blseds scarlet blood, the lower end dark
venoTls- l0red blood and this is not departed
from in q case of accidental injury unless there
have been previous disease N the limb. A
knowledge Of this fact OF Circumstance, which
continues for several days, vail prevent a mis-
take at the moment Of injury, and at subse.
uuent period, if secondary hemorrhage should
occur. Ia the upper extremity both enes OF Ene
DriucipaI artery bleed scarlet blood, from the
fee collateral circulation, and from the anasto-
moses in the hand. .-.r .t.F.
% From this cause, modification rarely takes
place after q wound Of the principal artery of the
arm, or even Of tac arm-pit. r .r ST.
Il fregucntly follows wound of the principal
sIteTy in the under, middle, or even lower parts
of tho thigh rendering smputahon necessary.
a. II is great question, when the bone is
unir rju-e5 wbcre and what part TIE amputatiOn
should be performed. Modification Of the foot
and leg, from such a wound, is disposed to stop
little below the knee, if it should moi destroy
the sufferer and tho operation, if done in the
first instance, as soon rs the tall0Wy or m0ttled
appearance of the foot is observed, should be
done at that pant the wound Of The artery, and
thsoperation for securing the vessel above and |
below the wound, being left unheeded. By this !
proceeding, when successful, the knee-joiut is !
saved, while an anlputation above the middle of
the thigh is always doubtful in its result.
%. When modification has taken place from |
any cause, and has been arres ted below the
knee, aud the dead parts show some sign ofsep-
Gration, tits usual to ampUtgte above the knee !
BY not doing if, but BY gradually separating and |
removing the dead parts, under the use Of disin-
feeting indictments and fresh air, good stump
may be ultimately made, the knee Joint and life !
being preserved which latter is frequently lest !
after amputating under such circumstances.
- Hospital gangrene, when it unfortunately /
occurs, should be considered to be contagious /
aad infectious, and is TO be treated locally by !
destructive remedies, such Is nitric acid, and the
bivouscinE or encampng Of tie renainder Of the |
wOuUd, il il can be Effected, CT their removal to
the open air.
30 Poultiees have been very often applied in
gau-sL0t wounds, from lazineSs, or to cover neg
lset, and should be used as seldom as possible. |
81 Chlgrotorm may be administered in all
cases Of amputation Of tie upper extremity and
bsl0w She knee, and il all miner operations
which cases may also be deferred, without dis
until the more serious operations are
performed.
32 AmputaGon CT tho upper and middle
parts of the thigh are to be done as soon as pos
sIpls after the receipt of tho injury. Tie adj
Hlinistratioa Of chioroforrn in them, when there
is much prostration, is doubtful, and must be
attended to, and observed with great care. The
question whether it should not be administered
in such cases being undecided. Il
"a. If the young surgeon should not feel
quite equal to the ready Performance Of the va
TioIs operations recommended, many OF them
requiring great anatomical knowledge and man
usl dexterity and il is not to be expected that
he should }, he sh uld avsl himself Of eVory oP-
portuHity which may offer Of perfecting bis
.-... ..-.. l.
The surgery Of the British army should be at
the hight Of the surgery of the metropolis, and
the medical officers Of that service should recol
ect, tina. the elevation at which it has arrived
has been on many points principally due 70 the
Ia5oTs OF their predecessors, during the war in
the Peninsula It is expected, then, that they
viii not only correct any errors into which then
may have fallen, but excel them By
the additions theiropPertunities win permit taen
to make in the Improvement of the great art and
science Of surgery. London Lancet for June.