CURIOUS SURGERY

Nelson Evening Mail, Volume LXIV, 17 January 1931, Page 4

CURIOUS SURGERY

SOME AUCKLAND CASES CHILD WHO ATE COGWHEELS Many strange a,nd puzzling problems present themselves to the medical fiaternitv from time to time, and in the course of a year the catalogued list of singular operations performed by the doctors in a city of a quarter of a million people assumes striking proportions. The. vast number of operations performed in Auckland during a peiiod of 12 months is naturally what might be termed prosaic, says the Now Zealand “Herald,” being associated with the treatment of diseases common to humanity, but there always remains a considerable collection which, through some unusual feature, has special claims on the public interest, . In this class are the operations wliioii have for their object the removal of foreign bodies from the human system. Such’operations, on a minor scale, are performed in the domestic realm every time a thorn is removed from a finger, or a mote extracted from an eye, but there are times when the amateur touch cannot successfully meet the case. It is then a task for the expert, hacked up by the cunning of science and the ingenuity of modern invention. Hundreds of operations of this type are performed in Auckland annually and, when the surgeons can be persuaded to describe them, make curious reading. There is the case, for instance, of the men who accidentally swallowed his dental plate, teeth and all. He was taken to the Auckland hospital, where the doctors, upon consultation, agreed that the obstruction could be removed without making an incision. They thrust an instrument, called an oesophagoscope, down his throat. The instrument embraces a tube fitted with a miniature electric light and a series of reflecting mirrors, by means of which a visual examination can be made of the gullet. Once located, a scissors-like instrument was lowered, through the tube and the dental plate neatly cut in half, the two pieces,bejngE thus easily removed. ' \! It is only a few years ago that the removal of obstructions in the throat, such as stones, coins and fish bones, to the swallowing of which adults, as well as juveniles, seem to be remarkably addicted, was accomplished by means of: a flexible wire and hook, which retrieved the annoying substance more, by chance than by design. This somewhat primitive method has now been superseded by the oesophagoscope. which can be used with amazing results without harm to the patient, Bordering on the absurd was the case, dealt with recently at the Auckland hospital, of a child who swallowed three little cogwheels of a toy train. Day by day the doctors anxiously watched with the X-rays the progress of the wheels through the body until, in the course of time, the three cogs, one by one, were recovered. A somewhat similar case was dealt with during the year by a private practitioner. A bootmaker was mending a sole with Ills mouth full of tacks when a friend, approaching unseen, slapped him on the back, with a cheery, “Hullo, how are you old chap?” The bootmaker promptly swallowed the taeks, about 20 in all, and then rushed to .a doctor. : Rather than use the knife, the doctor observed daily the travels of the tackp in the body, and eventually they. y;epe all recovered. %

There was also the case of a. child who tried to eat the coloured glass balls and trinkets off a Christmas tree. He munched them successfully, but unfortunately sucked them into the larynx instead; in other wo.rds, swallowed them down the wrong way. These minute pieces of glass were removed with the help of an instrument called the bronchoscope which, being passed downy the windpipe, enables the operator to see the small obstacles, much as in the case of the oesophagoscope, and pick them out with forceps attached to a long wire. During tho war wounds were caused mainly by separate bullets or pieces of shrapnel, which could be removed comparatively simply, but in peace time the shotgun is the principal cause of trouble and the post-war surgeon is called upon to extract innumerable pellets, often widely scattered. The modern way of operating in such cases is to rest the stricken member, say, the hand, on a glass screen through which X-rays pentrate. By turning the patient’s hand it is possible to locate the pellets and make the forceps meet them . accurately. This method of “screening” is now widely used in Auckland.

The small boy who gets a fishhook in In's foot or liis hand is a more frequent visitor to Auckland’s doctors than'the average person imagines. The procedure commonly adopted is to push the barb completely through the flesh, cut it off, and then pull the hook out. Numbers of workmen were operated upon at the hospital and by various doctors during the year for iron filings in the eye. When deeply embedded these are located by a special X-ray machine, worth £OOO, which maps out the exact position of the filing in the eye. When the irritant is of iron or steel, a giant magnet is frequently used with success. Other cases dealt with in Auckland during the past year included patients with peas, buttons and pebbles in the eye and nose, and a baby who ate large quantities of kapok.