It is a sight extremely interesting, to observe the gradual return of heat, strength and colour, to an arm on which the operation for the aneurism has been performed. I do not know that this operation was ever performed in the thigh, the artery being so guarded in this part, that an aneurism rarely forms here. I have seen the operation succeed very well in the inferior part of the leg, on the tibialis anterior, and the foot suffered but very little for a few days; it is true it is supplied with several other branches.
Some curious dissections of dead bodies afford a third argument, as the crural artery has been found quite obliterated in the upper part of the thigh, in consequence of a morbid cause, without the leg having been deprived of its nourishment, though supplied perhaps more imperfectly.
Warm water baths, in these cases where the circulation is to be promoted through the smaller vessels, and their diameters enlarged, are among the most efficacious remedies. Tissot.
[46] [§ XXXII.] It is long since the bolar earths have had the reputation of being useful in contusions, but this I am afraid is founded on a mistake; I have never, in any case, experienced the least effect from them that could induce me to think they possessed the virtues ascribed to them. True bole armenic might prove somewhat astringent in the first passages, but could not do any service in this way; or might suffer perhaps a small portion of the vitriolic acid it contains, to disengage itself; but four or five drops of the spirit of sulphur, would be more useful in this respect than a dose of the bole: Thus I am almost convinced it is of very little benefit in this composition, and if of any, it must be by blunting the action of the neutral salts, and preventing the uneasiness they sometimes occasion to persons of delicate stomachs. Tissot.
[47] I have seen an officer, a captain in the French service, who received a musket shot, with the muzzle of the piece close to the part; the ball shattered the humeral bone near its head, close to the articulation: had the wound been somewhat lower, that is less dangerous, his arm would have been taken off; the impossibility, or the difficulty of the operation prevented it; he suffered all the inconveniencies that a wound can occasion, for a considerable time several splinters were extracted, at length at the end of five months he was cured. This case appears to me of consequence, because here we see a very bad wound of that kind for which amputation is performed every day, and the danger aggravated by the nature of the part where it is inflicted, where they do not amputate, because it cannot be done, yet it was cured. If this officer had been so fortunate as to be wounded a few inches lower, he would have had the misfortune of having his arm taken off. Tissot.
[48]Fifty years, a compliment which Mr. Bilguer pays surgeons of a more modern date.
M. le Conte de B... a general officer in the Austrian service, received a wound much of the same kind, at Hochirken, and had the good fortune to be compleatly cured by M. Brunet, without amputation, which appeared indispensably necessary. He only continued a little weak, which in a man of his age and constitution generally goes off of itself: He was advised to go to the baths at Baden in Austria, and on his return was seized with an inflammatory fever, which proved mortal. Tissot.
SECT. [XXXVII].
I might enumerate the cases of a great number of wounded men cured in this way, but the instances I have mentioned may suffice to make it known; I shall only add, that even while I am writing, there are a great many patients in the hospitals at Torgau, whose bones were so broken and shattered, that hitherto surgeons would not have conceived that it was possible to cure them without amputation, and who are all nevertheless in the way of recovery, by the method I have recommended. There are very few surgeons of the army, who have not seen instances in our hospitals of patients whose limbs were to have been cut off, where to their great dread, every thing was ready, and they placed in order to undergo the operation, when, either from their fainting or their resistance, it has been put off, and recourse has been had to the method I have just pointed out, by which, contrary to the general opinion, they have been cured, have saved their limb, and used it afterwards with convenience. If we compare this with what has been said, [§ XXVII.] it will readily appear, that for the most part it is extremely wrong to amputate the limbs.