On hospitalism and the causes of death after operations / by John Eric Erichsen.

  • Erichsen, John Eric, 1818-1896.
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: On hospitalism and the causes of death after operations / by John Eric Erichsen. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    primary araputations. Indeed, its fatal results are al- most entirely confined to amputations performed within twenty-four hours of the infliction of the injury. I have never known a case of intermediate or secondary ampu- tation, or amputation for disease, in which the patient died from this cause. Fatal shock, in fact, is the result of the combined depressing influence of the in- jury and of the operation. It occurs in the exact pro- portion of the severity of the injury, the amount of loss of blood, and the age of the patient. It is often rather referable to the injury than to the operation; and it becomes a question whether, in many cases of serious and almost hopeless smash of a limb, it might not be better to let the patient expire in peace, than subject him to the repetition of a shock which his ner- vous system w^ill be utterly unable to endure. This is more especially the case in extensive crush and disor- ganisation of the lower extremity up to or above the middle of the thigh, such as are not unfrequent at the present day from railway accidents, in which the mangKng of the limb rather resembles that produced by cannon-shot than by an ordinary injury of civil life. In these cases amputation through the upper third of the thigh, or at the hip-joint, is the only available operation. It is usually done in such cases. But is it ever successful in the full-grown adult ? That is a ques- tion which deserves the serious consideration of hospital surgeons. I am not acquainted with a single case in which^ such an operation has succeeded in general hospital prac- tice, in men who have arrived at full maturity. In chil- dren and young adults it has proved successful. The three cases in which it was done, out of the eighty Uni- versity College cases, all died of shock. The same catas-