scrap'd with an Incision-Knife, and the Flesh with the Vessels that lie between the two Bones are to be cut. When the Flesh is thus separated, a Cleft Band is to be laid upon it, with which the Heads are cross'd, to draw the Flesh upward, to the intent that the Bones may be cut farther, and that it may cover 'em after the Amputation, as also to facilitate the Passage of the Saw. Then the Surgeon holds the Leg with his Left-hand, and saweth with his Right, which he lets fall upon the two Bones, to divide 'em asunder at the same time, beginning with the Perone or Fibula, and ending with the Tibia. But it is necessary to incline the Saw, and to go gently in the beginning, to make way for it, and afterward to work it faster. The Leg being cut off, the Ligature must be unty'd below the Knee, loosening the Gripe-Stick, to let the Blood run a little, and to discern the Vessels with greater facility; and then the Gripe-Stick may be twisted again, to stop the Blood; which some Surgeons effect, by laying Pieces of Vitriol upon the Opening of the Arteries, and Astringent Powders, on a large Bolster of Cotton or Tow, to be apply'd to the end of the Stump; but if such a method be us'd, it is requisite that some Person be employ'd to keep on the whole Dressing with his Hand during twenty four Hours. However this Custom hath prevail'd in the Hospital of Hôtel-Dieu at Paris.
Others make a Ligature of the Vessels, taking up the ends of 'em with a pair of Forceps, having a Spring; or with the Valet a Patin, which is a sort of Pincers that are clos'd with a small
Ring let down to the bottom of the Branches. These Pincers being held by a Servant, the Surgeon passeth a Needle with wax'd Thread, into the Flesh, below the Vessel, bringing it back again, and with the two ends of the Thread makes a good Ligature upon the same Vessel; then he looseth the Gripe-Stick and the Band, the Stump is to be somewhat bended, and the Flesh let down to cover the Bones.
The Dressing and Bandage.
After the Operation, it is requisite to lay small Bolsters upon the Vessels, and dry Pledgets upon the two Bones, as also many other Folds of Linnen strew'd with Astringent Powders; and over all another large Bolster or Pledget of Cotton or Tow, cover'd in like manner with Astringent Powders; then the whole Dressing is to be wrapt up with a Plaister and a Bolster, in form of a Malta Cross; so that there are three or four Longitudinal Bolsters, and one Circular.
The Surgeon usually begins to apply the Malta Cross and Bolster under the Ham, crossing the Heads or Ends upon the Stump, and causeth 'em to be held by a Servant that Supports the Part; then he likewise crosseth the other Heads, and layeth on the two Longitudinal Bolsters that cross each other in the middle of the Stump, together with a third Longitudinal, which is brought round about the Stump, to stay the two former: These Bolsters ought to be three Fingers broad, and very long, to pass over the Stump. Afterward he proceeds to apply,
The Bandage commonly call'd Capeline by French Surgeons, or the Head-Bandage.
Which is prepar'd with a Band four Ells long, and three Fingers broad, roll'd up with one Ball, three Circumvolutions being made on the side of the cut Part, the Band is to be carry'd upward with Rollers, passing obliquely above the Knee; and is brought down again along its former Turns; If it be thought fit to make this Bandage with the same Band, it must be let down to the middle of the cut Part, and carry'd up again to the Knee, many back-folds being made, which are stay'd with the Circumvolutions, till the Stump be entirely covered, and the whole Bandage wrapt up with Rollers or Bolsters.
The Capeline or Head-Bandage, having two Heads, is made with a Band of the same breadth, but somewhat longer. This Band being at first apply'd to the middle of the cut Part or Wound, the Heads are carry'd up above the Knee; and one of the Ends are turn'd backward, to bring it down, and to pass it over the end of the Stump. At every back-fold which is form'd above and below the Knee, a Circumvolution is to be made with the other end of the Band, to strengthen the back-folds, continuing to bring the Band downward and upward, till the whole Stump be cover'd: Then Rollers are made round about the Stump, and the Band is stay'd above the Knee. Afterward the Part may be brought to Suppuration, cleans'd and cicatriz'd.