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THE PROGRESS OF SCIENCE. 301
were seldom if ever implicated in wounds caused by. the
weapons in use at an earlier period. Amputation, but
seldom practised before, was now frequently required.
With increased experience the surgeons acquired great
certainty in performing these operations and began to
improve upon the methods till then in use. The chief
mistakes made were that surgeons had a tendency to postpone
them too long, to perform them when the soft parts
were unhealthy or gangrenous and to cauterize the stump
with the hot iron or with hot oil in order to arrest the
bleeding, and to remove the necrotic tissue. Important steps
in advance were therefore made, when BOTALLO demanded
the prompt performance of amputation, as soon as signs of
threatening gangrene presented themselves, and again when
surgeons once more began to make the separation in the
healthy parts, and finally when HANS VON GERSDORF, who
was able to boast that he had performed about 200 amputations,
covered the stump with moistened bladders and
applied cooling dressings, in this way securing for the
stump a sufficient covering of skin and soft parts which by
the employment of the hot iron used to be too extensively
destroyed. To prevent the danger of profuse haemorrhage
during the operation, the limb was constricted with bandages
above the line of incision. By the pressure on the
blood-vessels and nerves caused by the bandages, it was
hoped, as A. PARE states,* not only to prevent haemorrhage,
but also to diminish the pain and to bring about a local
anaesthesia. Ligature of the arteries which was again
recommended by A. PARI2 t afforded the greatest security
against the threatening haemorrhage.
This method, as has been said, was already known to the
surgeons of ancient times; in the middle ages also it was
occasionally employed by certain distinguished operators.
* CEuvres D'AMBR. PARE op. cit. T. ii, p. 222.
t CEuvres D'AMBR. PARE op. cit. T. ii, 226 et seq.- ADAMKIEWICZ : Die
mechanischen Blutstillungsmittel bei verletzten Arterien von Pare bis auf die
neueste Zeit, Wurzburg. 1872.