Some imagine that these violent contusions, accompanied with fractures,
require amputation, as the properest method of cure[36]. I shall
mention, what seems to me strongly against this opinion. In the first
place we must reflect, that the danger of dying, in these cases, does
not arise solely from the fluids extravasated in the contused part,
but from the violent concussion, which gives a shock, and occasions a
general compression of the vessels over all the body, especially the
internal ones[37]; and from the vessels being compressed, obstructed
or ruptured, proceed extravasation, inflammation and suppuration.
This commotion of the whole body, depends on the external air, which
being compressed, condensed, and rapidly pushed on by a ball, moving
with vast velocity, acts on the body with greater force, and causes a
more violent contusion, than any other substance, even the heaviest
has ever done. From thence proceed contusions of the viscera, spitting
and vomiting of blood, oppression, cough, pains, inflammations and
suppurations internally, a fever, and other complaints which happen
after contusions, seemingly slight, and confined to some particular
part, but which are, in fact, the consequences of this general, and
what may be called invisible, contusion of the whole body[38].
The amputation of the limb does not remedy those accidents; on the
contrary, it increases them, by means of the dread the patient feels at
the thoughts of amputation, and by the excruciating pain which attends
it; thus accelerating that death it was meant to prevent. I therefore
boldly affirm, that amputation cannot be of service in those cases,
wherein the nature of the parts and the state they are in, forbid it;
that in many, it is hurtful, and hastens death; and that in others,
even where the patient recovers, it is likewise improper, if he could
be cured and the limb preserved; a surgeon is unpardonable who employs
it in such a case.