Hixson’s Hoardings – Tidbits, gleanings and potins from your Kentucky Gateway Museum Center
In Kaye Browning’s latest exhibit, “Scaled to Perfection: Encore,” Pam Throop reproduced the Davidson Shop, an apothecary shop, in 1/12 scale, which still stands today in Williamsburg, Virginia, at the corner of Botetort and Duke of Rue Gloucester.
An apothecary was more than just a pharmacist. He performed all kinds of medical treatment. Besides making herbal remedies and concoctions, he performed surgeries, such as amputations, removing bullets, extracting teeth and was also the man-midwife! To give you a 1/12 scale idea, just look at the back of Davidson’s surgery and you’ll see an amputation kit leaning against the window. In Marla Toncray’s exhibit, “Teacups and Tools” on the second floor of the Wormald Gallery, you can find an original amputation kit – full size – complete with a saw, two long knives, a fabric strap and several other tools in a wooden box lined with red velvet approx. 1850 formerly owned by Dr LM Smith and given as a gift by Mrs Mitchell Denham.
In 1957, an American archaeologist, Ralph Solecki found the remains of a Neanderthal in Iraqi Kurdistan. This poor being died about 45,000 years ago and there is evidence that he lost an upper limb. Forensic science suggests that it was removed surgically, rather than by disease or trauma. What the researchers also found was that most amputations until ancient Greece were not due to medical necessities but to ritual reasons or punishment. If you were caught stealing, you would cut your hand. If you were accused of being lazy, you lost your footing. And, the way most cultures would stop the bleeding was to put the rest of the limb in boiling oil!
To find the beginning of amputation as a medical practice, we have to go to the Greek physician, Hippocrates, called the father of medicine due to the recognition of the use of prognosis and clinical observation, the categorization of disease, and he is credited with creating the Hippocratic Oath. He believed that amputation should only be used when a patient suffers from gangrene – a condition in which parts of your body begin to die due to a lack of blood supply. The way Hippocrates would amputate the affected limb is to cut only the dead tissue and leave any healthy tissue inside, then use cauterization and ligatures to stop the bleeding. Hippocrates replaced boiling oil with boiling water and values personal hygiene before an operation. However, he would not try to close the wound. Instead, he believed in letting the tissues heal on their own. But, despite her best efforts, most people died either during the operation or a few weeks after. The second major breakthrough came over 500 years later with a man named Celsus. Celsus was a 2nd century Greek philosopher and his From Medicina was a source on food, pharmacy, surgery and related fields, and “it is one of the best sources of medical knowledge in the Roman world”. He would amputate some of the living tissue in order to make a clean cut.
“It made healing easier because there was less surface to heal. After the amputation, he did not leave the wound open. He would start by cutting the bone slightly shorter and leaving some extra skin. Then he would pull the skin and muscle tissue over the bone and sew the skin together. While his practices were definitely an improvement, his procedures were not aseptic and his death rate was still quite high. From there, surgeons began using amputations for trauma, birth defects, and cancer. But a problem remains. After cutting a leg, the patient was losing a lot of blood, so they invented a tourniquet to prevent blood from entering the limb. (Remember there was no anesthetic. The patient was still fully awake and able to see his severed leg!) They found that cutting some nerves would at least reduce the pain after the operation.
Everything changed in the Dark Ages. Much of the medical knowledge about amputation was not necessarily lost, it was simply not being used. Most of the surgeons were men of the fabric and they put more into “faith in religion than in science”. There was still a demand for amputation – better to lose a leg than to lose your life! So barbers took up the profession. They were skilled with the knives, but without any knowledge of how to amputate, the practice essentially declined. “There was no cleansing of wounds, no cauterization and no proper cutting of bones and nerves. As a result, the patients suffered and died needlessly. “
China had already used gunpowder in the first firearms, the Fire Lances, which contained shrapnel in the 10th century. It made its way on the Silk Road and the first use of guns used in combat in Europe dates back to 1421. “The use of gunpowder with bullets and cannonballs can break bones and leave shards of metal in the flesh of nearby men. The muskets did not fire small bullets. “They fired bullets up to 3 centimeters in diameter. When he hit a soldier, he took a piece of clothing in the wound. So even if you remove the bullet, there may still be some tissue inside that will start to get infected and infect your entire limb. With the invention of the printing press, the books of Celsus and those who followed him were copied and published throughout Europe. Surgeons could once again learn how to properly amputate a limb, saving countless lives. New techniques could be disseminated easily. “In 1452 it was suggested that all amputations should be done just below the knee or elbow. He standardized amputations so that they were easier to perform, he also allowed surgeons to make cuts where medical complications were least likely to occur. In the 16th century, the first above-knee amputation was performed by Ambrose Pare ‘. He apprenticed with his older brother, a barber-surgeon in Paris, and became a student at the Hôtel-Dieu, the oldest hospital in France. He was a barber-surgeon to Kings Henry II, Frances II, Charles IX and Henry III and is “considered one of the fathers of modern surgery and forensic medicine and a pioneer of surgical techniques and medicine. battlefield”. He invented several surgical instruments, including arterial forceps. He used ligatures of the arteries instead of cauterization during the amputation. Over the following centuries, the tourniquet was improved to cut off the blood flow even more. They improved the procedure of beating the skin and muscles on the bone and improved the way a limb would be cut. “At the start of the 19th century, the emphasis was on getting the amputation done as quickly as possible. Some surgeons would complete an entire amputation procedure in less than half a minute believing that the shorter a patient, the safer they would be. When the anesthetics were used, the doctors were finally able to operate without keeping the patient’s pain in mind, allowing for more complex operations and now we have antibiotics to treat any infections ”and the operating room is sterile. Most injuries can be treated without removing limbs. In some cases, they can reattach a member. Humanity has come a long way. For my part, I am grateful for modern medicine!
Questions can be sent to [email protected] @ Kentucky Gateway Museum Center, Maysville, KY