[Treatment of open fractures before Lister and the management of the fatal leg fracture of Admiral Michiel Adriaensz de Ruyter, 1676].

On 22 April 1676, Admiral De Ruyter suffered a fatal open fracture of the right lower leg during the naval battle near the Etna. The fleet doctor, Jan Mannart, and the two ship's surgeons treated the wound with brandy and prescribed rest, but fatal gangrene developed a few days later. Before Lister first reported his technique of antiseptic treatment in 1876, the possibilities for the treatment of open wounds were limited to cauterisation and application of hot oil. Until the middle of the 19th century, amputation of the wounded limb was the most obvious solution. Why amputation was not performed in the case of De Ruyter is unknown. Actually, however, amputation would probably have increased his chances of survival only to a limited extent.