Two Letters concerning the Use of Agaric, as a Styptic

XCIX. Two Letters concerning the Use of Agaric, as a Styptic. LETTER I. From Mr. Joseph Warner, F. R. S. and Surgeon to Guy's Hospital, to Thomas Birch, D. D. Secr. R. S. SIR, Hatton-Garden, Decem. 3, 1754. Read Dec. 5, 1754. The inclosed paper is a letter, which I received a few days ago, by the hands of William Fellowes, Esq; a very worthy member of the Royal Society; the contents of which I am desirous should be communicated to that learned body, as they tend to give a farther confirmation of the good effects of the agaric of the oak, in stopping of bleedings after a division of some of the most capital arteries. At the same time, I have taken the liberty of adding, that I have continued to make use of this application with the greatest success; and for many reasons do continue to be of opinion, that it is one of the most valuable acquisitions, that has at any time been made in our profession. I am, Sir, Your most obedient servant, Joseph Warner. LETTER II. To Mr. Joseph Warner. SIR, Shotesham, Novem. 10, 1754. I return you thanks for the agaric of the oak, which I received by Mr. Fellowes, and send you an account of the effect I have observed it has had, according to your desire, that you may have the satisfaction of seeing I have made no unprofitable use of your favour. Two or three days after I received it, I was desired by an ingenious surgeon to be with him upon business. I carried some of it with me, and he was pleased with the opportunity of trying it in an amputation below the knee of a boy of about ten years old. We applied it according to the directions given in your book, which I have read with pleasure and profit, and the haemorrhage was entirely stopped in six minutes. He informed me, that, on the 5th day inclusive, the dressings and agaric came all off without force, and left the stump in a good digested state, without the least appearance of blood; and that the pain, in consequence of the operation, did not require an anodyne. He cut a boy for the stone the same day, and a vessel bleeding rather more than is thought allowable, he applied a very small piece of the agaric, and a soft doffil of lint over it, which, with gentle pressure of the finger, restrained the bleeding in less than a minute. My own patient, aged near seventy, whom I made trial of it upon, the 23d of the last month, in amputating his leg below the knee, appeared as proper proper a subject to establish the credit of this new styptic as could be produced, if it failed not in its efficacy; there being in him a great depravation of the fluids, and a general relaxation of the solids; and he had an ulcer upon his leg, of the phagedænic kind, of many years standing, attended with carious bones. Under these discouraging circumstances he applied to me about a month before, and begged of me to take off his leg; the pain, he said, being so violent and continual, that he knew not how to live with it: and tho' I looked upon him as a very bad subject for the operation, yet I did not care to deny his most earnest request, seeing no other possible means left of affording relief in his miserable condition. Considering the rigidity of the fibres in an old person, and that their natural contractile power, evident in the division of an artery, must be greatly weakened in this case, I was afraid, that the agaric, if it should answer, would not act so expeditiously as it did in the other; and that probably we might meet with much more difficulty in restraining the hæmorrhage. Therefore, to afflit it all I could, I tacked it to thick compresses of lint with pieces of card in the middle, thinking by that means I could apply it more readily, and keep it in stronger and closer contact with the mouths of the vessels, if I should find it necessary; for indeed I was very solicitous for the support of its credit and reputation, my own being connected in some measure with it, and the patient's welfare also depending upon it. I applied most of the pieces without being under a necessity of having the tourniquet-ligature slackened, to shew the mouths of the vessels; then covered the stump thick with lint, ap-plied plied a pledget of tow spread with common digestive over it, and over that a circular piece of stiff paper, to make the pressure of the palm of the hand more equal. This done, after three or four minutes I desired my assistant to slacken the tourniquet-ligature; upon which it bled at a great rate, and made some of my brethren soon imagine, and declare, they thought it would not do in this case. I was not without the same fears; but we went on with resolution, and every thing was conducted by us without hurry or confusion. I desired to have the tourniquet-ligature let quite loose, in order to remove, as much as possible, all impediment to the reflux of the blood, and made strong compression at the end of the stump, upon which the bleeding almost instantly abated, which was totally stopped in about half an hour after; and, in the whole, I believe he did not lose more than twelve ounces of blood. Now, apprehending that the circular structure of the common bandage, as usually applied, might produce the same inconvenience, which I observed arose from the tourniquet-ligature before it was quite loose, if no other attended it, having strong suspicions of strait bandage doing much mischief; I therefore only put several strips of common plaister, about an inch broad, over the piece of stiff paper at the end of the stump, to meet and lap over at the top of the knee when bent, and then flipped on a barber's woollen cap; which method seemed to us to answer the purpose very well in this, as I have found it do in some other amputations. A physician, and four surgeons of eminence, who were desirous of seeing the effect of the agaric, were present at the operation. Four days after I opened the stump, stump, but took away no more of the dressings than what were loose, amongst which were two or three pieces of the agaric, without any signs of fresh bleeding, or visible pulsation at the ends of the arteries. Two days after I dressed it again; the stump then appeared well digested all over, and had a much better aspect than could reasonably be expected in such an unpromising subject; and now appearances are so favourable as to give me hopes of his recovery, tho' I am not without distant fears, which I am guarding against as much as I can. I have lately been informed by very intelligent people, in the county of Suffolk, that they gather an excrescence, growing there plentifully upon oaks, and call it Funk, which, impregnated with nitre, is used as a match to light pipes; from whence I conclude it is the same with the Fungus igniarius, mentioned in the Mem. de l'Acad. Roy. de Chirurgie, and have herein inclosed a small piece of it for your examination, which appears to me of the same kind with the agaric I had from you. Though the chief use made of it in Suffolk is by smoakers, yet 'tis often used, they assure me, to stop bleeding, and cure small wounds, and has been so for time immemorial. If I have trespassed too much upon your time in this detail, I beg you would excuse me, and for the freedom, with which I write, as if I was acquainted with you: but the subject appears to me a matter of that interesting nature to all mankind, that I think it should and must engage the most serious regard and attention of every one, to shew his inclination in support of it what he can; and I hope the success of future trials, in your conspicuous station, will convince the public, that this new styptic, which creates no pain (unless what may sometimes proceed from the necessary degree of pressure in the application of it), may be relied upon in all cases, where the needle and ligature has hitherto been thought the least painful, and only secure means of stopping blood in the arteries. A happy discovery indeed, should this prove the consequence of it, as I heartily wish it may, for the ease and benefit of the miserable part of mankind, who fall under our hands; and am, SIR, Your most obliged humble servant, B. Gooch. C. Extract of a Letter from Mons. Bonnet, F. R. S. of Geneva, to John Clephane, M. D. F. R. S. translated from the French. Geneva, June 3, 1754. Read Dec. 12, 1754. THE inoculation of the small-pox continues to be attended with the greatest success in our city. Of seventy, who were inoculated, there was not one in any danger. Lausanne has been as it were forced to imitate us; and we hope, that this excellent method, which we received from England, will spread itself from one place to another, for the good of mankind. Mons. de la Condamine has read to the Royal Academy of Sciences at Paris a dissertation upon this