DELICATE WORK. SKILFUL SURGERY IN A NEW YORK HOSPITAL.

Te Aroha News, Volume IV, Issue 165, 14 August 1886, Page 5

DELICATE WORK. SKIL FUL SURGERY IN A NEW YORK HOSPITAL.

A Cam in WUob docfclne Wwi tfaed , with .Advantage. ' ;; . "New- York,' Juno 5,-rrlfcVaa one of the bloodiest operations in surgery, amd frequently ttao hemorrhage" got beyond the surgeon's control, .and the death of the patient Via expected. ■Margaret Forater, , a middle-aged . and comely woman, is the patient, and Bellevne Hospital -is the plaoe that she left recently, feeling bo much relieved that everything she looked upon in the' bright, sttnehiny world had a new interest for her. ' She passed most of her life at Newburg on the Hudson, and until about a year ago had never knoWn what it was to be sick, and then she discovered that she was unable to breathe VitH freedom through her nose. ' The difficulty was. increased when lying dowb^arid'tbis -prevented her from getting her accustomed sleep. u . *' >- j *'* -'• 't'i.'« A physician was tried, and he diagnosed the^case as a spinal difficulty ' exercising' a jreflex action on the,organs of respiration. rest "the toatieht must have, and sfie was keptcin r b'ed, where all thfe symptotns were aggravated tenfold, until, she lingered on the borders of . insanity,' and thought 'of suicide as a remedy that would bring relief. She got worse all the time. The difficulfjr in breathing increased, and finally bec»mVß6'pronbunc©cl tnat'ndfc-a^pariJele of air could *"be "drawn fthrbuQl? the nostrils, and the poor woman .went around with her mouth wide open, gasping for breath. The §hy«ical strain as Well fctnienfal -worry reuced the woman's weight and vitality to a .great extent, and as eh"c could not take nourishment with any certainty of it 'doing 3good,there was only one end to her malady, and this was the*question of time. She came to this city, and was- recommended to a distinguished throat specialist 'at fiellevue. She got there on Saturday inorning, and it was afternoon .. before she could be examined. Then the surgeon puta speculum into her nose,- and' found with no trouble the cause of all her suffering. The difficulty was not catarrhal, but hanging from the top of the nasal space down rfnto the back passage was a tumour. It stiould be felt from the mouth easily, and there was only one thing could be done, and r th&t was to take it out. In the old surgery this was a serious undertaking. After the patient had been -aneatbetised the throat and mouth were j packed with layers ot cotton, and then the > windpipe was split open and a tube inserted, so that breathing could be carried on independent of the mouth. Then the cheek was opened, and the bone sawed through and the tumor torn out with forceps. The blood would spurt out in every direction, and in consequence ot the confined fepace the surgeon had to work in, the bleeding points could not be picked up except by chance, and there were many recorded cases of death. The blood was kept out of the lungs by the cotton, and when this became saturated it would stream out of the patient's mouth. But this was all changed, and in an hour ..-after the patient came to the hospital she was in the operating-room. While Her -mouth was held open as wide as possible, -the palate, tonsils and neighbouring parts were thoroughly painted at intervals with •cocaine, the 4 per cent solution. The liquid was also injected up the rear nasal passage and into the nose. Tests - were made at intervals to find the effect of the cocaine, and in about ten minutes the -tongue, throat and inside of the nose were without sensation, and instruments could be passed into the throat and moved aronnd - without causing spasms of gagging. While .•the patient's head, was drawn backward a , loop ot platinum .wae run through the left nostril and delicately manipulated until ■the end could be seen in the back of the throat. It was then expanded and placed -Around the body of the tumour, and a gentle - tension being put on *the hanging from the nose, the loop was drawn upward until it * encircled the pedicle, near its point of - contact The tumor did not adhere to the membrane -in the nose save at the pedicle. Flexible canulas were slipped over the wire and run into the nose as far as possible, so that the only part exposed was that touching -the pedicle. The ends ot the wire hanging from the nose were then - attached- to the poleß of a galvano-cautery battery,- and, after another injection of cocaine, was sent tip the nostril/ the current was turned on * by the touch of a button. A white cloud of smoke came flying out of the nose and mouth of the patient as the platinum became hot and Sank into the pedicle. ' The patient did not even wink, and, as the - smoke had a sort of broiled beef odour, she - did not mind that. The handle holding the wire had a screw attachment by which %the loop could be contracted at will, and when the hot wire 'had cooked the tissue near it a slight torn of the* screw would send it deeper into the hissing flesh. It took altogether about three * minutes to draw it entirety- 4 through the -pedicle. To [prevent the tumour when severed from dropping into the' patient's throat an instrument with a hook' was in--serted through the mouth; and the tumuor was seized by it j and drawn out.' 1 It was pear-shaped, and weighed 1 about six ounces, and after it had been shown 1 to the astonished patients, who had no idea of what was going on, it was put mto 1 a labelled~jar ' for preservation. There was not a particle ' of "hemorrhage during the operation, and no^ pain was felt save; where the hot wire -touched some part of 'the tissue which had not been rendered perfectly inseneiblet by the cocaine. Thin was -not disagreeable, and the patient eaid it J wao only a slight sting, and lasted but a iecand. The patient was relieved immediately after the tumor was removed, and ' she* breathed through her nose for the first time rin many months. In half an hour she wai walking around feeling perfectly well, and could have left the hospital then .without any inconvenience but she concluded to wait till the next day, when she went home, and there was only a little' soreness Jn the tuose. • * *'