546 



MILITARY SDEGEEY AND MEDICINE. 



tain amount of extension and counter-extension 

 upon the thigh. The difficulty of applying the 

 splint and roller, when a change of dressing is 

 required without disturbing the limb at the 

 seat of fracture, is a serious objection to this 

 splint. 



Dr. Hodgen has invented a wire-splint as a 

 substitute for his cradle which possesses some 

 advantages over Smith's. It is made of No. 2 

 iron wire, the centre and upper part being kept 

 apart by strong bars of iron, and the limb is 

 suspended in it as in his cradle by strips of 

 cloth, while small hooks on each side serve for 

 the attachment of cords attaching it to a pulley 



FIG. 23. 



Dr. Hodgen's "Wire Suspension Splint. 

 FIG. 24. 



Child's Elastic Crutch. 

 FIG. 25. 



Shracly's Leg Splint. 



above. Extension is made by adhesive straps 

 as in the cradle (fig. 23). As a means of sup- 

 port for fractured limbs during amputation, Dr. 

 Elisha Harris, of the Sanitary Commission, has 

 introduced into the supplies furnished by that 

 Commission, metallic troughs made of perforat- 

 ed tin, which have proved of great value for 

 the purpose. 



In fractures of the bones of the leg, the use 

 of some apparatus for the support of the leg, 

 and to keep it in a position of perfect rest, is 

 indispensable ; and it is absolutely necessary 

 that this should be raised so as to swing clear 

 of the bed, or shortening of the limb and great 

 irritation of the wounded tissues will ensue. 

 A suspended box, with bran to pack 

 around the limb, to check the oozing 

 of either blood or pus, to prevent the 

 wound from being infested with mag- 

 gots in warm weather, and act as a 

 sufficient lateral and back-support to 

 the limb, is one of the simplest and 

 most effective plans for keeping these 

 fractures in place and in a fair way 

 for recovery. " Salter's cradle," in 

 which the box is suspended upon pul- 

 leys, which run in an iron groove or 

 rail, is convenient for the purpose of 

 adjusting the position of the wounded 

 limb to any involuntary motion of the 

 body ; but perhaps the simplest and 

 most ingenious of all is the suspend- 

 ing apparatus invented by George F. 

 Shrady, A. A. Surgeon U. S. A., by 

 which, by the aid of the clamps which 

 attach it to the bedstead, any degree 

 of elevation can be given to the limb, 

 and it can be placed at any inclina- 

 tion (fig. 25). 



The old question agitated in all 

 treatises on surgery, and on which 

 military surgeons have differed so 

 widely, of the best time for ampu- 

 tating a wounded limb, has been a 

 matter of serious discussion during 

 the war ; the great preponderance of 

 authority among the eminent army 

 surgeons is, however, in favor of pri- 

 mary amputation, and that at as ear- 

 ly a moment as possible after the in- 

 jury. The point to be ascertained, 

 these surgeons say. is, whether the 

 wounds received are of such a nature 

 as to preclude the hope of saving tbe 

 limb. This decided in the affirma- 

 tive, the sooner it is removed the 

 better for the patient. The neces- 

 sity of moving the patients often to 

 great distances, and the danger of 

 poisoning the air of crowded hospi- 

 tals by the effluvia from suppurating 

 and sloughing wounds, renders am- 

 putation necessary oftentimes in mili- 

 tary practice, where in civil practice 

 it might be possible to save the limb. 

 The best method of amputation, 



