ON AMPUTATION 381 



be mentioned that of Richard Wiseman, Sergeant-Surgeon to King Charles IT 

 A fillet having been tightly applied, for the threefold purpose of checking 

 haemorrhage, rendering the limb less sensitive by pressure on the nerves, and 

 steadying the soft parts, which were retracted by an assistant, he carried a 

 crooked knife by a single circular sweep down to the bone, which was dix'ided 

 with the saw at the same level, and the bleeding was arrested by the cautery, 

 or some kind of styptic.^ 



Thus the mode of amputation employed by the father of British surgery 

 only two centuries ago was precisely that used fifteen hundred years before by 

 the Roman Archigenes. x\nd very unsatisfactory were the results which it 

 commonly afforded. The soft parts were insufficient, even in the first instance, 

 to cover the end of the bone, which was accordingly cauterized, with the object 

 of accelerating its inevitable exfoliation, and in the further progress of the case 

 it tended to become more and more exposed by the contraction of the muscles ; 

 and even if the patient survived the protracted suppuration that ensued, he 

 suffered more or less from the inconveniences of what has been called the sugar- 

 loaf stump, being in the shape of a cone, the apex of which was formed bv the 

 prominent bone, covered either by a sore which refused to heal, or bv a thin 

 pellicle of cicatrix, very liable to abrasion. 



A great step towards a better order of things was made in 1674 by the French 

 surgeon Morel, in the invention of the tourniquet,- which though at first but 

 a rude contrivance, being a stick passed beneath the fillet and turned round so 

 as to twist it up to the requisite degree of tightness, furnished the basis for the 

 greatly improved instrument devised in the early part of the following century 

 by his distinguished countryman, J. L. Petit. This consisted essentially of 

 two metallic plates, which could be separated from one another by means of 



' The ligature, though known to Wiseman, seems not to have been adopted by him. After 

 describing different modes of applying it, in a way that shows prettj^ clearly that he had not practised 

 them, he writes, ' But the late discovery of the royal styptic hath rendered them of less use. But in 

 the heat of fight it will be necessary to have your actual cautery always ready, for that will secure the 

 bleeding arteries in a moment, and fortify the part against the future putrefaction." — Chintrgical 

 Treatises, book vi. 



■ English surgeons might dispute with the French the honour of the in\cntion of the tourniquet. 

 In a work written in 1678, published in 1679, entitled Ciirrus Triumphalis e Terebintho, Mr. James Young, 

 of Plymouth, gives an account of a similar contrivance, apparently produced independently by himself. 

 He describes it as ' a wadd of hard linen cloth, or the like, inside the thigh, a little below the ingucn ; 

 then, passing a towel round the member, knit the ends of it together, and with a baltoon or bedstaff, 

 or the like, twist it till it compress the wadd or boulster so very straight on the crural vessels that (the 

 circulation being stopped in them) their bleeding, when divided by the incision, shall be scarce large 

 enough to let him see where to ajiply his restrictives ' (p. 30). Further on in the book he states that the 

 same principle is applicable with advantage in amputations of the upper limb. But as he docs not 

 inform us how long he had used this expedient before he wrote the account of it, the credit of priority 

 must of course be accorded to Morel. 



