Swords Chisels and Guillotines

Legal and punitive amputations performed with swords or axes may have stimulated surgeons to operate in this way. According to Harley, the Masai tribe in Kenya amputated for severe compound fractures very deftly, by means of a long sword on a block.49 Woodall, one of the first to mention special chisels and mallets (see Fig. 9.2) for instantaneous amputation, restricted this application to fingers and toes. He and others noted that chisel amputations at higher levels resulted in splintering of bone and frequently incomplete division of soft tissues, particularly tendons and nerves,50 resulting in more than one blow before completion. Fabry considered this a cruel method, unworthy of a rational surgeon, yet he recommended a guillotine machine for the same purpose, consisting of two large blades set in timbers weighted with lead, basing his favorable opinion on a report by Master Cognomine but without supportive case histories (see Chapter 8).51 However, Purmannus, one of the last authors to illustrate chisels for digital amputations, in 1706, also recorded witness accounts of two double-bladed machine guillotine sections through the shin which ended badly, concluding it was much better to amputate in the ancient way with knife and saw.52 As also noted in Chapter 8, Mayor raised the possibility of instantaneous cutting, termed by him "tachytomie," yet offered no practical solution.53

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