False accusation in the Royal Medical and Chirurgical Society against a poor man because he suffered no pain while his leg was amputated in the mesmeric coma : and cruel refusal of the Society to receive his solemn denial of the truth of the false accusation / By Dr. Elliotson.

  • Elliotson, John, 1791-1868.
Date:
1851]
Catalogue details

Licence: Public Domain Mark

Credit: False accusation in the Royal Medical and Chirurgical Society against a poor man because he suffered no pain while his leg was amputated in the mesmeric coma : and cruel refusal of the Society to receive his solemn denial of the truth of the false accusation / By Dr. Elliotson. Source: Wellcome Collection.

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    plunged his knife into the centre of the outside of the thigh, directly to the bone, and then made a clear incision round the bone, to the opposite point on the inside of the thigh. The stillness at this moment was something awful; the calm respiration of the sleeping man alone was heard, for all other seemed suspended. In making the second incision, the position of the leg was found more inconve¬ nient than it appeared to be;’ and Mr. Ward, to use his own words, * having made the anterior flap,’ * was under the necessity of com¬ pleting the posterior one in three stages. First, by dividing a por¬ tion of the flap on the inside ; then a similar portion on the outside. This proceeding, which was of course far more tedious and painful than the ordinary one, was necessary to enable me to pass the knife through under the bone and thus complete the whole, as I could not sufficiently depress the handle to do so, without the two lateral cuts.’ Yet, notwithstanding all this, the patient’s ‘ sleep continued as profound as ever. The placid look of his countenance never changed for an instant; his whole frame rested, uncontrolled, in perfect stillness and repose; not a muscle was seen to twitch. To the end of the operation, including the sawing of the bone, securing the arteries, and applying the bandages, occupying a period of up¬ wards of twenty minutes, he lay like a statue.’ “Soon after the second incision, ‘a low moaning* was heard at intervals until the conclusion of the operation, that is, after the leg was off and while the arteries were tying and the bandages putting on, giving ‘to all present the impression of a disturbed dream.’ That it arose from troubled dreaming I have no doubt; for in the mesmeric coma it is common for patients, after the lapse of a cer¬ tain time, to dream and talk, and especially if anything has just before strongly impressed them ; and this patient was very likely, and from my experience I should say was almost certain, to dream of his having soon to undergo the operation, the thoughts of which had so acutely distressed him and must have occupied his mind to the last moment of his waking state. I have at this moment three patients who in the coma always dream and talk of something which has very recently, generally the same day, interested them, or of something they expect on the same day. Had it arisen from the operation, it would have occurred during the most painful periods ; would have occurred, as it did not, exactly and only at moments of the proceeding most likely to be painful, whereas it occurred as much at moments when nothing was doing to give pain. The man could not have moaned from pain in spite of himself at moments when there was nothing to make him moan in spite of himself. It would have been increased, and indeed changed to a sudden and louder noise, whenever the end of the sciatic nerve was roughly treated. For, still farther to test his insensibility, Mr. Ward ‘twice touched’ and, as he informs me, pretty roughly and with the points of the forceps, so that he in fact pricked, ‘ the divided end of the sciatic nerve, without any increase of the low moaning.’ The pain which such an experiment would occasion to a person in his ordinary state must be equal to a strong dart of tic douloureux; and I defy any