A Letter from Mr. Ra. Calep, to Mr. William Cowper, F. R. S. concerning a Woman 62 Years of Age (Who is Still Living) That Lost Her Leg and Greatest Part of Her Thigh by a Gangrene

IV. A Letter from Mr. Ra. Calep, to Mr. William Cowper, F. R. S. concerning a Woman 62 Years of Age (who is still Living) that lost her Leg and greatest part of her Thigh by a Gangrene. The Wife of Tho. Steven of Maidenhead in the County of Berks, (aged about 62 Years,) was seized with a Fever about the latter end of November 1697. Her Physician used various Remedies to remove her Fever, which in about 14 days terminated in a Tumor and Nummets in her left Foot, both which did by degrees creep up her Leg, and half way up her Thigh. A Fomentation was order'd by her Physician made of Centaur. Absinth. Hyperic. &c. boil'd in a strong Lixivium; and after fomenting, he order'd them to Anoint her Foot and Leg with Ol. Terebinth. wherein Galbanum was dissolved. This Method they had used daily for a Month before I saw her. Coming Jan. 3. 1678. from Henly upon Thames (where I then lived) to see some Friends and Relations I had at Maidenhead, they desired me to go and see this Poor Woman; which I did, and found her in the following Condition, (viz.) Her Foot and Leg cold, insensible, wither'd, hard as if dry'd in a Chimney, and of a dark Tawney Colour. Her Knee was swell'd, and had several large black Spots upon it, which pitted when prest with my Finger. There was several Discolourations in the Skin, half way up her Thigh. She complained of great Pains, especially at Nights, in her Knee and Thigh, yet cou'd not feel me when I touched those Parts. Her Fever was now encreased again, and she was delirious sometimes. She begg'd heartily of me for help; but alas! what cou'd I propose to to relieve her? Nothing but the taking off her Thigh, which she would not consent to. I was not sorry for her not admitting of that Operation, because I could not expect any Success in the performing it, by reason of her Age, Weakness, &c. So I took leave of her, supposing I should never see her more. I advised her Friends to continue the use of the Fomentation, which they did almost Night and Day. About a Month after, I coming to Maidenhead, was surprized to find this poor Woman alive. There was now a discharge of a Black Fætid Matter, at a small Orifice about the middle of the Inside of her Thigh, which Orifice I enlarged to make a better discharge for the Matter. I likewise cut into a Tumour that appeared upon her Knee, but found nothing in it but Wind. I then took my leave of her, (as before) advising to continue fomenting daily. About a Month or 5 Weeks afterwards, I came to Maidenhead again, and found her alive, and to my admiration saw that, which thro' the whole course of my Life I may never see again, (viz.) how Nature had made a perfect Separation of the mortify'd Flesh from the sound, quite round the Thigh, the Bone of the Thigh lying wholly bare above the breadth of 4 Fingers, and deprived of its Periosteum. The Flesh above was fresh and florid, and had good white Matter upon it. I now perswaded her to let me take off her Thigh, which I did about 2 Fingers breadth in the sound Flesh, (because the Flesh run tapering down to the Bone,) by which I made the Stump pretty even. The Bleeding was little, by reason that the Veins and Arteries (which were eaten asunder by the mortifying Matter) Nature had closed again. I Drest the Stump with Pul. Refring. mixt with Album. Ovov. spread upon Pledgets, and dipt in Ol. Terbinth. hot. The next Dressings I used Digestives, and performed the rest of the Cure according to the Rules of our Art. The Woman is alive to this Day, and now liveth in Maidenhead over against the Bear Inn. I wou'd have preserved this Leg to have dissected it, but the Friends of the Woman deceived me. They promised me to keep it for me till the next day, which I relying upon, left it with them. So they took that opportunity to Bury it, where I never cou'd find it. I shall forbear sending you my poor Reflection on this case, for fear I shou'd not judge aright. But shall leave it to you, and others, who are more Competent Judges than August 23. 1707. Yours, &c. Ra. Caleps. About the beginning of October last I happened to be at Maydenhead, where I saw the Woman whose Case is here related; she appeared to be very decrepid, and would have shewn me the Stump of her Thigh bare, but the coldness of the Weather, she said, would make it uneasy to her. I felt it through her Cloaths, and the end of the Stump seem'd to be not above four or five Inches below the Trunk of her Body. Since I have so frequently found the large Trunks of the Arteries of the Thighs and Legs of Aged People petrified, as I have mention'd in the Transactions, Numb. 280. and most commonly in those who have had Gangreens in the Legs, &c. I am apt to suspect the like happen'd in the Crural Artery of this Woman; which, like a Legature, did at length put a total stop to the Influent Blood below that Stricture. Novemb. 27. 1707. William Cowper.