While comparing mortality rates of country practitioners with those operating in the large, urban hospitals of London and Edinburgh during this period, the obstetrician James Y. Simpson discovered some shocking differences. Of twenty-three double amputations performed on patients in the countryside over a twelve-month period, only seven died. Although this statistic may seem high, it is low when compared with the mortality rate at the Royal Infirmary of Edinburgh for the same period. Of the eleven patients who received double amputations there during this time, a shocking ten of these died.
