Today’s Resected Yet Truly Morbid Fact!
During the American Civil War, the type of surgical treatment and the timing of surgery represented the chief decisions faced by trauma surgeons. Records in the South from earlier in the war showed that nearly 65% of all wounds were extremity wounds; twelve separate Union records showed more than 71% of all wounds were of the extremities. Orthopaedic treatment was generally classified into three types: conservative (expectant), excision (resection), or amputation. The philosophy of choosing one of these treatments shifted during the war. As the war continued and surgeons became more experienced, they also became more conservative. There were proponents of resections who felt that life and limb were to be saved by such a surgery. Arguments against resection and for amputation included useless limbs, longer hospital stays, and an increased infection rate. Amputation was regarded as the most aggressive surgical approach. Many surgeons gained the reputation of Saw-bones if their colleagues felt they were quick to amputate a limb. In order to assist surgeons making the decision of whether to amputate or excise, guidelines were distributed in the form of handbooks or in medical journals. These guidelines included amputation if the limb was nearly amputated from the initial injury or if there was extensive soft tissue damage, neurovascular injury of major nerves or blood vessels, or open fractures of the joints or thigh. Recommendations for excision only without amputation included gunshot wounds of the fingers, toes, wrist, shoulder, elbow, and ankle if the major nerves and arteries escaped injury. Resection was only advised if the guidelines for amputation were not met. Also, amputation from gunshot wounds of the upper two-thirds of the thigh and hip joint had such high mortality, surgeons were told not to amputate at these levels. In these areas death from the amputation approached 100%. Amputation was also excluded in cases where the soldier was mortally wounded elsewhere, such as the chest, head or abdomen. The surgical approach also varied based on whether an upper or lower extremity was injured. Surgeons tended toward conservative approaches when treating injuries of the distal upper extremity (hand and wrist) and the proximal lower extremity (thigh region).
Ghastly! – Amputation Edition
June 21, 1865 by Reed Brockaway Bontecou. In this remarkable carte de visite, Private Parmenter lies unconscious from anesthesia on an operating table at Harewood Hospital in Washington, D.C. To save his patient’s life, Doctor Bontecou amputated the soldier’s wounded, ulcerous foot. Before the discovery of antibiotics, gangrene was a dreaded and deadly infection that greatly contributed to the high mortality rate of soldiers during the Civil War.
Culled from Pinterest.
Ghastly! – Angular Vein Edition
Here’s another excerpt from Mütter Museum of the College of Physicians of Philadelphia by Gretchen Worden.
The Angular Vein (1993) – Shelby Lee Adams
Face demonstrating the angular vein, prepared by Oscar V. Batson, M.D. (1894-1979), Professor Emeritus of Anatomy, University of Pennsylvania School of Medicine, according to the method of Professor Werner Spalteholz of Leipzig (1861-1940). The tissue is rendered translucent and immersed in a mixture of methyl salicylate and benzyl benzoate, allowing visualization of the vein, which has been injected with a contrast medium.