OCR Text |
Show AMPUTATION OF THE THIGH. AMPUTATION or rm: rr‘non. niquet was unscrewed, and on the compress being taken of}; blood started from the face of the stump. The tourniquet on another occasion was put on withthe screw half elevated, and during the operation the moveable piece reached the top of the screw so that it was impossible to tighten it farther. A young assistant, mistaking the first jet of blood from the distended veins for the springing of an artery, put his whole strength to the tourniquet, until the strap tore upon the buckle. It might have broken it altogether, as happened to Gooch, from this over-anxiety. I have seen a surgeon apply the tourniquet with the buckle so near the brass roller, that it checked and prevented the operation of the sereu', or the fur- CHAPTER VI. AMPUTATION OF THE THIGIL 'RUMENTS AND APPARA'I L‘ EL . 7, -. m wraith" . llllilllli"&‘ WM , ' ‘ NM _ ~ 269 . Two tourniquets-Roller and compress-flannel or linen roller-Adhesive straps-Lint-conlpresses for the stump. and Malta-cross laid out-Tow-Sponges-Tenacula, three ' ' forceps-Needles-Ligatures-Cloth re» at1 easst--Dissectmg tractors-Amputation-knife-Scalpel-SaumAmputation-for~ cops-Wine and waten ther tightening of the ligature. During operation, I have seen the arterial bleeding taken for venous blood, and a loss sustained that destroyed the patient; and therefore I have sometimes recommended, "here there were great VCinS' to put a film" :ery tightly drawn, about the limb, below the place of the meision, which keeps the operation altogether free from blood, and informs the u ‘.-.\ para "~9- ~'-=' ‘ 4: 1 The patient is seated on a firm table, with a friend behind to support him in his arms, Attendants are on each side of him to take hold of his hands, While another is seated before assistant whether he ought to tighten the tourniquet: any jet of blood, then, in the first incision, is iot from the distended veins, but the arteries. It may be said, that the colour of the venous blood is a sufficient indication of its nature ; but in experience I have found surgeon applies the tourniquet : and in general, in a great apes it otherwise. I have again and again, in this operation, as roll as in the extirpation of tumours, seen the patient lose ar- rationphe settles all the lesser previous circumstances; at the terial blood to a dangerous extent, while it was thought that same time assuring the patient, and fortifying his faith in the surgeon. 'l‘he tourniquet is applied about a hand's breadth from the it was only venous blood. Where there is a suspicion of abscesses having formed grom. him on a low stool, to hold the injured limb. The assistant amongst the muscles, the tourniquet ought to be applied, as A young gentleman put the roller far removed from the disease as possible. Should the tourni«1not give way, or the tongue of the buckle slip, the mere idea. of which is alarming, the assistant should press his thumb up on the artery, as it escapes from the belly, whilst some one grasps the face of the stump until a new tourniquet be applied, and compress which is placed under the tourniquet so fight, or a handkerchief twisted about the limb, as described in the that the Circulation of the artery was not free after the 10m" introduction, The pulsation of the artery is felt, and the compress put down upon it, and seated there by one or two turns 0f the attached bandage. On this the tourniquet is appliedThe errors which I have seen committed in this simple and prevrous step are these. '7‘" ' ,thNl M059"). ‘ ' 1 |