The miller’s tale

Account of the man with his arm torn offIn 1737 the Philosophical Transactions published a medical case so remarkable that it was still being quoted in journals well over a century later. It was reported by John Belchier, a surgeon at Guy’s Hospital in London and a Fellow of the Royal Society. The Gentleman’s Magazine from 1745 contains this anecdote about him:

One Stephen Wright, who, as a patient, came to Mr. Belchier, a surgeon, in Sun Court, being alone with him in the room clapt a pistol to his breast, demanding his money. Mr. Belchier offered him two guineas, which he refused; but, accepting of six guineas and a gold watch, as he was putting them in his pocket Mr. Belchier took the opportunity to seize upon him, and, after a struggle, secured him.

An obituary published after his death in 1785 reported that Mr Belchier felt such compassion for his assailant that he paid for him to receive a hot meal during every day of his subsequent incarceration. But enough of these diverting asides; there’s gory medical history to be told. In his Philosophical Transactions paper Mr Belchier narrated the following extraordinary tale, which took place in a windmill in east London: 

Samuel Wood, about 26 years of age, being at work in one of the mills near the Isle of Dogs, over-against Deptford, and going to fetch a sack of corn from the farther part of the mill, in order to convey it up into the hopper, carelessly took with him a rope, at the end of which was a slip-knot, which he had put round his wrist; and passing by one of the large wheels, the cogs of it caught hold of the rope, and he not being able to disengage his hand instantly, was drawn towards the wheel, and raised off the ground, till his body being checked by the beam which supports the axis of the wheel, his arm with the shoulder-blade was separated from it.

Ouch. Or at least you’d think: 

At the time the accident happened, he says he was not sensible of any pain, but only felt a tingling about the wound, and being a good deal surprized, did not know that his arm was torn off, till he saw it in the wheel.

Put yourself in Samuel Wood’s shoes for a minute, and imagine spying an arm stuck in a piece of machinery and only then realising that it was yours.

When he was a little recovered, he came down a narrow ladder to the first floor of the mill, where his brother was, who seeing his condition, ran down stairs immediately out of the mill to a house adjacent to the next mill, which is about 100 yards distant from the place where the accident happened, and alarmed the inhabitants with what had happened to his brother; but before they could get out of the house to his assistance, the poor man had walked by himself to within about 10 yards of the house, where, being quite spent by the great effusion of blood, he fainted away, and lay on the ground; they immediately took him up, and carried him into the house, and strewed a large quantity of loaf-sugar powdered into the wound, in order to stop the blood, till they could have the assistance of a surgeon, whom they sent instantly for to Limehouse…

Loaf-sugar is a solid block of sugar, the form in which it was sold before the advent of granulated sugar. It may seem strange to pour the latter on a wound, but this was often used in such scenarios and is still a common folk remedy in many developing countries.  There has even been some recent interest in investigating the antimicrobial properties of granulated sugar in wound management.

…but the messenger being very much frighted, could not give the surgeon a clear idea of the accident, so that when he came to see the condition the man was in, he had no dressings with him for an accident of that kind; but had brought with him an apparatus for a broken arm, which he understood by what he could learn from the messenger to be the case.

Equipment which was certainly inadequate for the task in hand.

However, he sent home for proper dressings, and when he came to examine particularly into the wound, in order to secure the large blood-vessels, there was not the least appearance of any, nor any effusion of blood; so having first brought the fleshy parts of the wound as near together as he could by means of a needle and ligature, he dressed him up with a warm digestive, and applied a proper bandage: the next morning he opened the wound again, in company with 2 surgeons more; and not perceiving an effusion of blood at that time, he dressed him as before, and sent him in the afternoon to St. Thomas’s Hospital, where he was admitted a patient under the care of Mr. Ferne; from which time he was constantly attended, in expectation of a hemorrhage of blood from the subclavian artery; but there being no appearance of fresh bleeding, it was not thought proper to remove the dressings during the space of 4 days, when Mr. Ferne opened the wound, at which time likewise there was not the least appearance of any blood vessels; so he dressed him up again, and in about 2 months time the cure was entirely completed.

Pretty amazing. He might well have been dead in twenty minutes from a wound like that.

On examining the arm, within a day or two after it was separated from the body, they found the scapula fractured transversely, as were likewise the radius and ulna in 2 places: but whether these bones were fractured before the arm was torn off, the man cannot possibly judge.

It seems safe to assume that a triple fracture in a patient who had his arm ripped off by industrial machinery was probably caused by the accident rather than being a freak coincidence.

But it is very surprising, that the subclavian artery, which could never be got at to be secured by art, should not bleed at all after the first dressing; the artery being separated so happily, that when the coats of it were contracted, the fleshy parts pressed against the mouth of it, and prevented any effusion of blood.

Samuel Wood
Samuel Wood and his arm (click to enlarge)

The subclavian artery is a major blood vessel which branches off the aorta, near the heart. Severing it in this way would usually result in catastrophic loss of blood and – if it remained open – rapid death. Young Mr Wood had every reason to think himself very lucky indeed.

In the later editions of his Anatomy of the Human Body (first published 1713), William Cheselden included a handsome, if surreal, engraving of Samuel Wood staring forlornly into the middle distance. His severed arm stands in the foreground, with a windmill – the instrument of its destruction – poignantly in the distance.

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