Last night Paul Harvey told his listeners in excruciating detail about the agony suffered by a little boy enduring an amputation back in, oh, 1880-ish. The surgeon had to cut through the lad’s skin, muscle, bone & marrow with a hacksaw while the lad had no choice but to scream in agony :eek:.
Here’s what I don’t get: the guillotine (sp?) had been around for decades prior to the development of anesthesia. So why couldn’t pre-modern doctors just place the offending limb in the guillotine and get it over with quickly? It’s flawless: a clean cut, minimal pain, and it’s over with in a fraction of a second?
So what prevented the use of the guillotine in pre-modern amputations?
To amputate a limb you need to tie off the veins so the blood stops spurting out. Also you need a bit left over to make a stump. A really clean cut would leave nothing left to create a stump.
It is also very hard to carry a guillotine around the countryside. A doctor could fit some whiskey and a hacksaw in a handbag, jump on his horse, and ride. Carryong around a big ol’ guillotine would require a carriage and slow him down.
Just seconding andyj’s response. The first criterion for any amputation procedure is that it must be survivable. Guillotine (or axe) might be fast, but then the individual would exsanguinate pretty damn quick. Before anesthesia, they had to be quick, but they still had to tie off the arteries, and if possible, go thru joints rather than bone, and as already mentioned, make some kind of closed stump to minimize risk of future infections (not that infection control was a strong point of pre-anesthesia medicine).
If Paul’s story was set in the 1880’s, it wasn’t because anesthesia hadn’t been invented yet, it was because the doctor didn’t happen to have any. Here’s a short history of anesthesia.
The surgeon would leave one or strips of skin attached, being longer than the actual stump, so that he might suture the skin over the raw end of the stump, kinda like wrapping a present. The surgeons also heated their saws when possible, not necessarily for anti-sepsis, but because warm saws hurt less. If the patient was conscious, a leather strap would be folded and placed between the teeth, to prevent the patient from actually breaking his own teeth in his agony. If a strap wasn’t available, a bullet might be used as bite-block (hence “Bite the Bullet”).
Considering the rough-n-ready methods, a surprising number of people survived amputations in the Seventeenth, Eighteenth, and Nineteenth Centuries.
You can find a very interesting chapter about anesthesia in Michael Crichton’s book Five Patients. This was written while he was a medical student, long before he became a famous author.
Crichton quotes something written in the pre-anesthesia days about amputations. The patient was carried to the operating room, and the surgeon asked him, “Will you have your leg off, or will you not have it off?” If the patient said no, he/she was carried back to his/her room. If the patient said yes, the assistants grabbed him/her, held him/her down, and the surgeon did what he needed to do.
If you can find a copy of the book, it’s fascinating reading. It was written in the late 60’s, and it’s amazing to see how far medicine has come in 30 or 35 years.
The measure of a great surgeon was partly in how speedy he was with the saw. They were often timed to the second and great pride taken in a particularly fast time.
I recall a story about a fast time that was much admired, not with standing the fact the surgeon took off the fingers of his assistant at the same time.
An excellent (fiction) book on the subject is “Ingenious Pain” by Andrew Miller.
There was a famous microbiologist of the time who got his start as an army surgeon. I want to say it was Lister, but I don’t think that’s right. Anyway, in his memoirs, he talks about one battle where he amputated several hundred legs in an hour, using a shovel heated in a fire. That’s right - we’re talking a few seconds per amputation.
I’ll have to dig out my old History of Micro notes and see if I can find a reference.
Unfortunately, it’s not just a historical issue. I read an interview a few years back with a doctor who was working with Medicine Sans Frontieres (Doctors Without Borders). They are an organization out of France who supply doctors in relief areas, refugee camps, etc. They sometimes have to operate without anesthesia, because there are more patients then drugs.
One of the questions he was asked in his initial interview was, “How fast can you saw through a leg?”
I remember that when I think I’m having a bad day at work.
Paul Harvey was telling a story about how the same day that that hideous operation was going on, a few blocks away, a nitrous oxide demonstration was taking place, with roughly four thousand people paying a quarter to get high on the stuff. And no connection was made between nitrous oxide and its pain-killing properties.