The Routledge History of Disease by Mark Jackson

Author:Mark Jackson
Language: eng
Format: epub, pdf
ISBN: 9781134857944
Publisher: Taylor and Francis
Published: 2017-02-14T16:00:00+00:00

Amputation and its discontents

The most common prostheses were those intended to supply the loss of limb, either through congenital defect or amputation.19 In the past, as today, the most common use of amputation applied to the lower limbs.20 In the eighteenth century, amputations were used in response to a series of medical circumstances.21 The Prussian army surgeon Johann Ulrich Bilguer in his 1764 treatise on amputation described six common causes where dismemberment was ‘universally thought necessary’, including: mortification reaching the bone; ‘a limb so hurt, that a mortification is highly probable’; trauma such as ‘violent contusion of the flesh which at the same time has shattered the bone’; amputation as a preventative measure to stop life-threatening haemorrhage; ‘incurable caries [rottenness] of the bones’; and cancer.22 In some cases, amputation was carried out in response to a progressive worsening of health whose exact causes were difficult to pinpoint. For instance, the Derby Mercury reported in 1727 the case of a 69-year-old man for whom amputation was proposed after mortification spread down his right leg. The mortification was ‘occason’d by an ill State of Health he had labour’d under for a considerable Time, which at last fix’d itself in the Foot, attended with great Pain, Swelling and Inflammation’.23 However, most popular accounts of amputation, found among the plentiful lists of ‘casualties’ printed in eighteenth-century newspapers, described amputations that were the consequence of traumatic accidents or injuries.24 For example, one Mr Swain of Lad Lane in the City of London was reported to have undergone an amputation in July 1754 after an accident in which he was thrown out of a chaise, breaking one of his legs and ‘continues so dangerously ill, that ’tis feared he cannot recover’.25 In 1758, Henry Therond of Trinity College, Cambridge, fell from his horse ‘whereby he broke his leg in such a terrible Manner that both the Bones forced their way through his boot’ so that the leg ‘was obliged to be cut off’. Once again, there were ‘but small Hopes of his Recovery’.26

When the surgeon Percivall Pott described limb amputation in 1779 as ‘an operation terrible to bear’ and ‘horrid to see’, he expressed a view that was commonplace in an age before anaesthetics.27 Amputation was often described as a ‘melancholy’ procedure; patients were said to ‘submit to an amputation’, indicating resignation to their fate.28 Nevertheless, the belief that there were certain circumstances where its use was unavoidable made amputation, in Pott’s view, an act of ‘humanity’, which reflected the rational judgement of medical professionals.29 But in the second half of the eighteenth century the procedure of amputation was a matter of keen debate, raising questions not just about the necessity and safety of the operation, but also about the authority and competence of surgeons and the extent of their power over the patient’s body. Amputation might proceed from a humane wish to save life by removing a diseased or shattered irrecoverable part, but it highlighted the role of medical intervention in causing disablement, leaving those who survived the procedure in a ‘mutilated imperfect state’.

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