with ordinary skill, not more than one death will happen in twenty 
cases, and even in less proportion. Te Seep, 
The circumstances in this operation, that more particularly re- 
quire attention, are, the choice, when this is in our power, of the 
part at which a limb should be amputated; the prevention of 
hemorrhagy during the operation ; the division of the skin muscles 
and bones in such a manner as to admit of the stump being com- 
pletely covered ; the tying of the arteries alone, without including 
the nerve or any of the contiguous parts; securing the teguments 
in a proper situation, so as to prevent their retraction after the ope- 
ration; and a proper after treatment. . » aepter: 
Next to securing the patient against loss of blood, it is most im- 
portant to save so-much of the soft parts as willcover the stump, s0 __ 
as to heal the sore by the first intention’; for without this the wound 
is large, the cure tedions, and the discharge apt to be so great as 
to endanger the patient’s health. 
Various means of amputating have been practised in different 
ages, and improvements made from time to time, till the science 
may now be considered as quite perfect. The method practised 
and recommended by Mr, Benjamin Bell, appears to be the most 
rational and successful, however; and I shall therefore give itin 
his own words: } it ti be sta ee 
OF AMPUTATING TRE THIGH. 
in amputating the thigh or leg, the patient should be placed upon _ 
a table of ordinary height with the leg properly secured and sup- 
perted by an assistant sitting before him. The other leg should — 
likewise be supported, at the same time that the arms s be se- 
cured by an assistant on each side, to prevent interruptions during 
the operation. 
The flow of blood to the limb should now be stopped by the ap- 
plication of the tourniquet. The manner of using it is this: leta 
cushion, three inches in length, by one inch and a half in diameter, 
be formed of a linen roller, tolerably firm, but not so hard as to ren- 
der the pressure produced by it painful: this being placed upon the 
course of the principal artery of the limb, let it be firmly secured by 
One or two turns of a circular roller of the same breadth with the’ 
cushion itself. The tourniquet with the strap connected with it, 
being now placed upon the limb, with the handle of the screw on 
the side of the limb opposite to the cushion, the strap is to be carried 
round the limb over the cushion, and tightly buckled on the other 
side. When proper attention is given to this, a single turn of the 
screw proves sufficient for putting a stop to the circulation of blood 
in the limb. The instrument should be placed as near as poss 
to the top of the thigh, and the cushion upon the thigh artery 
— reach to the groin. Bint peer seo thighs Be ; 
ith respeet to the proper place for amputating , y 
be said on a general maxim, that no more of it should be taken’ 
away than is rendered necessary by the disease ; for the more of it — 
that is left, the more useful it proves. sets & Soe 
_ Aw assistant should now be directed to grasp the upper par 
limb with both hands, and to draw up the skin and cell } 
