This is another set of drawings that I did for the International Museum of Surgical Science in Chicago. For more information about my time there, please see Flesh and Bone # 5. These pictures show the steps of an amputation (in this case, the right leg) as it would have been performed during the period of the American Civil War (1861-1865.) During this period, surgical technique was not standardized and every experienced surgeon created his own variations on basic procedure. For this series, I tried to come up with an "average" amputation based on many different accounts published in the medical literature of the time. I have exaggerated the musculature and omitted blood and infectious material to make the illustrations clearer.
Drawing 1-This person has received a bullet wound to the leg. Though the injury was not initially life-threatening it has become infected. At this time, the germ theory of disease (and antibiotic drugs) is still many years away. The leg must be removed to stay one step ahead of the disease. The leg could be removed at the crotch, but that would severely limit the
patients mobility upon his possible recovery. In this case the surgeon has elected to perform the amputation slightly above the knee. If the patient recovers, he will have the chance to be fitted with a prosthesis (peg leg.) Like most surgeons at the time, the doctor performing this operation with instruments that have wooden handles. These wooden handles soak up blood and infected material like a sponge, increasing the spread of disease. A tourniquet has been applied a few inches above the chosen site. A knife cuts through the layers of skin and fat an it is rolled up the leg like a sock-this layer of skin will be sewn together at the end of the operation to create the stump.
Drawing 2-The surgeon brings the knife down sharply (in the manner of a meat cleaver) until it strikes the bone (femur.) He then runs the knife around the circumference of the bone, severing all of the muscles.
Drawing 3- The surgeon holds back the layers of muscle while he saws the bone. He has not washed his hands and transfers bacteria to the
patients wound.
Drawing 4-The arteries and veins are tied off.
Drawing 5-The flap of excess skin is rolled down and sewn together to create a stump. The tourniquet is removed. Unfortunately, no provision to drain the wound has been made and there is likely to be a large amount of fluid build-up. Bacteria thrive in places that are warm, dark, and wet-exactly the conditions to be found at the end of this stump. As a result of surgical techniques like this, a soldier in the American Civil War was more likely to die than a soldier with a similar wound serving under
Napoleon or Julius Caesar. In earlier times, the treatment for a wound like this would be to sever the leg completely above the knee and then coat the exposed flesh with a layer of hot tar. This served to cauterize the wound and kill the bacteria present. Next time-the last installment of Flesh and Bone.
This is another set of drawings that I did for the International Museum of Surgical Science in Chicago. For more information about my time there, please see Flesh and Bone # 5. These pictures show the steps of an amputation (in this case, the right leg) as it would have been performed during the period of the American Civil War (1861-1865.) During this period, surgical technique was not standardized and every experienced surgeon created his own variations on basic procedure. For this series, I tried to come up with an "average" amputation based on many different accounts published in the medical literature of the time. I have exaggerated the musculature and omitted blood and infectious material to make the illustrations clearer.
Drawing 1-This person has received a bullet wound to the leg. Though the injury was not initially life-threatening it has become infected. At this time, the germ theory of disease (and antibiotic drugs) is still many years away. The leg must be removed to stay one step ahead of the disease. The leg could be removed at the crotch, but that would severely limit the patients mobility upon his possible recovery. In this case the surgeon has elected to perform the amputation slightly above the knee. If the patient recovers, he will have the chance to be fitted with a prosthesis (peg leg.) Like most surgeons at the time, the doctor performing this operation with instruments that have wooden handles. These wooden handles soak up blood and infected material like a sponge, increasing the spread of disease. A tourniquet has been applied a few inches above the chosen site. A knife cuts through the layers of skin and fat an it is rolled up the leg like a sock-this layer of skin will be sewn together at the end of the operation to create the stump.
Drawing 2-The surgeon brings the knife down sharply (in the manner of a meat cleaver) until it strikes the bone (femur.) He then runs the knife around the circumference of the bone, severing all of the muscles.
Drawing 3- The surgeon holds back the layers of muscle while he saws the bone. He has not washed his hands and transfers bacteria to the patients wound.
Drawing 4-The arteries and veins are tied off.
Drawing 5-The flap of excess skin is rolled down and sewn together to create a stump. The tourniquet is removed. Unfortunately, no provision to drain the wound has been made and there is likely to be a large amount of fluid build-up. Bacteria thrive in places that are warm, dark, and wet-exactly the conditions to be found at the end of this stump. As a result of surgical techniques like this, a soldier in the American Civil War was more likely to die than a soldier with a similar wound serving under Napoleon or Julius Caesar. In earlier times, the treatment for a wound like this would be to sever the leg completely above the knee and then coat the exposed flesh with a layer of hot tar. This served to cauterize the wound and kill the bacteria present. Next time-the last installment of Flesh and Bone.
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