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[Page 19]
After a spell of about half-an-hour, Dr. Ollerhead, Surgeon Todd, and myself, with the assistance of 3 volunteers, got the theatre cleaned up with lotions, dressings, and instruments ready, and recommenced operations. The patient was a German with a shattered right leg, which was fractured & mutilated in the middle third. The wound was horribly offensive and alive with maggots, ΒΌ inch in length, gangrene had set in, and infection was spreading up the veins to the thigh. This was 36 hours after injury.
There was a tourniquet round his leg just above the knee, and though the man must have lost a good deal of blood, his condition was very fair considering all things. Under chloroform it was decided to amputate above the knee. This was done by anterior skin flap, and a modified skin & muscle flap by transfixion posteriorly. A good covering was obtained with a very satisfactory stump. Some difficulty was experienced in finding the large arteries, as they did not bleed freely on loosening our tourniquet. The patient was put to bed in the sick bay at 4 a.m. with two German sailors to watch over him. He began to kick the stump about on coming to, and had to be tied down. A large dose of morphia was administered, and we retired to rest after a cup of bovril at 4.30 a.m.
No sooner was I in bed than I was called up to this case and found him pulseless. Strychnine was administered and heart massage and artificial respiration tried without success. It was most disappointing, and I was unable to decide whether he had died from shock or from morphia poisoning. Possibly the latter as I had such disappointing results with our morphia previous to this case that I increased the dose. An injection into the vein after