Moments in Surgical History |

Amputation vs Nonamputation

Ira M. Rutkow, MD, MPH, DrPH
Arch Surg. 1999;134(11):1284. doi:10.1001/archsurg.134.11.1284.
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DESPITE THE FACT that approximately 60,000 amputations were performed, the great surgical controversy of the Civil War concerned amputation vs nonamputation. Conservative surgeons and their overtly concerned civilian supporters wished to save a wounded extremity at any price. The radical "cutters" believed only in prompt amputation. At the start of the hostilities, conservatism seemed to hold sway. As early as June 1861, the US Sanitary Commission, a civilian-organized soldiers' relief society, authorized the printing of an American edition of the British Surgeon-General George Guthrie's (1785-1856) Directions to Army Surgeons on the Field of Battle. From his experiences at the Crimean front, Guthrie expounded the conservative viewpoint that a "leg should be seldom amputated for a fracture from a musket ball."

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Woodford Longmore, a Confederate private, was wounded on June 11, 1864, during a brief skirmish at Cynthiana, Ky. Not until January 1866, following an 18-month tortured existence of chronically draining abscesses, unrelenting elimination of necrotic bone fragments, and unrelieved pain, was an amputation finally completed at the hip joint.

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