“A memoir on amputation of the thigh at the hip joint with a successful case” William Sands Cox 1845 The progression of wound healing during the period 1776-1899 as depicted in various works of the Plymouth Historic Collection Wendy Slater Student I.D. 91027353 Objective: Discover how the treatment and understanding of open wounds has developed throughout history; focussing on infection, inflammation and amputation. Moses Griffiths 1776 Practical observations ….to which is added, a method of treating several kinds of internal haemorrhages. John Bell 1795 Discourse on the nature and healing of wounds A.P. Buchan 1804 Practical observations concerning sea bathing Astley Cooper 1821 A series of lectures on the most approved principles and practice of modern surgery. William Sands Cox 1845 A memoir on amputation of the thigh at the hip joint with a successful case Thomas Pridgin Peale 1858 On amputation by a long and short rectangular flap Florence Nightingale 1860 Notes on nursing: what it is and what it is not H. Helfeich 1899 On fractures and dislocation Amputation: Thomas Peale 1858 constructed a statistical analysis of a new amputation technique, using long and short flaps to create a stump that could weight bear comparing it to the usual “circular amputations” that were happening in London, with poor patient outcomes. Inflammation and healing: Although infection was poorly understood; inflammation due to tissue damage was noticed clinically and commented upon throughout all historical works: “Arteries…inosculate mouth to mouth…each cut surface throws out mucus…entireness of the part is so quickly restored” Bell 1795 “the necessary leakage from [tissues] produces a swelling… the equable bondage of nature … confining the limb in the situation the animal placed it…continuing till the injured ligament or tendons have recovered themselves” Griffiths 1776 “Slight febrile disturbance is produced” John Bell [on amputation techniques 30 years previously] “no motive for saving skin…no notions of adherence…6-8 inches of skin amputated” Bell criticised certain surgeons in his day: “They all still dress their amputations as separate soles till the twelfth day”. “Illustrations of the great operations of surgery: trepan, hernia, amputation, aneurism and lithotomy” Charles Bell (n.d.) “On fractures and dislocation” H. Helfriech 1899 “A system of operative surgery” Charles Bell 1809