“But, to put this proposal as strongly as possible, let us recall the experiment that we had the occasion to make ourselves, after these days which have just been described, on a quite large number of wounded whom we considered would have been covered by the rule that would have condemned them to amputation without preparation. [This experiment was done] in the hope that we would have a less equivocal success and also in order to affirm the principles by tests repeated sufficiently to overcome the disbelief of the most prejudiced. Ten English wounded, out of a number of about one thousand who had been taken to the hospitals of Douay after the battle of Fontenoy, were therefore set aside. Their wounds were such that amputation was essential in most of them because many of them had been wounded by cannon-shot: it was simply a question of whether the amputation was carried out sooner or later.”
“The following are ten cases very suitable for supporting the principles that we are setting out here (a). Though, using the ordinary method, one sees so many amputees perish, I had the good fortune to save the ten [patients] I had reserved, by preparing them for amputation. Had this experiment been carried out on only one, two, or even three wounded [men] who were recovered by this method, that would even so have been a favourable indication of its reliability. But it seems to me difficult not to be impressed by an experiment repeated ten times and always with the same success. This is particularly so in the type of wounds in question which required three amputations of the arm, including one through the [elbow] joint, two of the thigh, three of the leg and two of the forearm.
(a) I have as witnesses of these ten cases Messrs. Majaut, père et fils who both signed the account that I sent to M. de la Peyronie; Messrs. Dufour & Henri, surgeons working at the Hôpital de Douay; & M. Delaire, Surgeon-aide Major of the army, who visited the wounded to report on them to M. Andouillé, Surgeon-Major.”
“M. Réad, Surgeon-major at the Hôpital de Valenciennes, from whom we took the first three observations [of a list set out on previous pages], assures us that he has thirty wounds complicated by bony fractures, [though] these are, in fact, less grave than the first three because almost all of them were cured without amputation, although, if the ordinary rules had been followed, most of them would have required immediate amputation. Of nine hundred wounded who were taken to the Hospitals of Valenciennes after the battle of Fontenoy, the number of amputations was reduced to eleven; nine of these were completely cured though their amputations were carried out between the tenth and fifteenth day after wounding, and [only] in response to the external signs in the parts affected and because the patients were better prepared.
This, then, is a method whose success is confirmed by everything. [There were] mutilated limbs [which were, presumably, saved] which would have been extirpated according to the usual procedure and would have put the patients into greater danger of losing their life; and [there were] a greater number of happy outcomes from amputations; the number of these which are successful under the ordinary system is estimated by some people to be, at most, one third but this is contradicted by the observations which we were able to make after the battle of Fontenoy where the number of successes in about three hundred amputations was merely thirty or forty. On the other hand, if we put together just the cases of M. Réad and those…”
“That we ourselves were able to make using the other principles [i.e. the delayed operation], the loss, [i.e. deaths] far from reaching the expected one third of the number of amputees, does not even reach one tenth. This is a prodigious difference which must make a greater impression on the feelings of the Académie since it is a matter that concerns that good of humanity in general to which is consecrated all the care and glory of Surgery. For all that, one must not hide the fact that such a great difference in proportion [of deaths] must be moderated by a certain number of patients who died following immediate amputation, or a little afterwards, who would also have perished had the amputation been delayed.”
Translation by Ulrich Tröhler