At the end of about six weeks the patient may be allowed to get up and lie on a sofa or sit with the leg on another chair, but the limb must not be permitted to hang down. After about three months he may be allowed to get about, but in order to prevent the detachment of the grafts, he should be fitted with a knee-rest and peg on which he walks, the leg projecting out behind him. If possible he should not put his foot to the ground until six months have elapsed. In cases of sores on other parts of the body, when the erect posture does not cause congestion of the part, the patient may be allowed to walk about after the first three weeks.
Results. The scar which results after skin-grafting performed in this manner is of a satisfactory character, and ulcers which have been intractable for years may be closed satisfactorily by this means. In order to obtain anything in the nature of a permanent cure, however, the prescribed period of rest must be adhered to rigidly.
CHAPTER XX
LOCAL ANESTHESIA
History. From Corning we learn that the ancient Assyrians alleviated and even entirely prevented the pain incident to circumcision by compressing the veins in the neck. Unconsciousness was probably induced in this way together with pressure on the carotids.
In India, centuries ago, the effects of opium and of Indian hemp were known and employed, and the ancient Egyptians were also conversant with the soporific effects of many drugs. We learn, from the same authority, much which he gathered from literature about the history of local anesthesia, and it is from Corning’s well-known book on local anesthesia that most of this history is quoted.
In Peru, the Spanish conquerors learned that the coca loaf was held in high esteem by the natives, inasmuch as they observed that it was chewed by the high priests and nobility only, the vulgar being denied this privilege except as a reward of great merit or of distinguished valor. The leaf was regarded with awe and superstition and was supposed to possess supernatural powers. After the fall of the Incas, the Spanish not only permitted but encouraged the general use of the leaf in order to obtain more work from the natives, a result which the drug seemed to effect. It was also a source of great revenue to them and was sold at exorbitant profit to the natives who became enslaved to its effects but were able to endure great hardship while under its influence.
Chemists throughout the world, recognizing the potent action of the coca leaf, were soon engaged in the effort of extracting its active principle.