SOME OF THE WONDERS OF MODERN SURGERY.

Tuapeka Times, Volume I, Issue 19, 20 June 1868, Page 3

SOME OF THE WONDERS OF MODERN SURGERY.

(Feom the Atlantic Monthly.) We are told by a well known and un doubted authority, that the rich Mis Kilmansegg once met with a serious acci dent; "But what avails gold to Miss Kilmansegg, "When the femoral bone of her dexter leg Has met with a compound fracture ? " asks the historian ; and he further states that as " the limb was doomed, and i couldn't be saved," it was cut off, an< that after its removal there was an im mense amount of trouble in fitting to tin remaining portion of the member an^ kind of an extremity. If the lady hac lived in our advanced days, no apprehen sion would have been felt. A letter t< one of those manufactories where legs anc arms — in the shape and motion of whicl Apollo or Venus might exult, and whicl in nineteen caaea out of twenty are fai more beautiful to look upon than Nature's own — are turned out to order by stean would have caused to be sent by returi train a perfectly suitable leg. The very wonderful and perfect me chanism which is introduced into these patent extremities is only equalled by the facility with which they are used. Thej are light, they have all the movements of the natural joints, and, by means oi springs, wires, cords, and wheels, wori with a precision which is very surprising. Not long since I had the pleasure of being accosted in the street by a well dressed soldier, who, in nobly doing battle foi his country, had been shot through the knee, the lower parts of his leg being so severely shattered that it was necessary to remove it. The poor fellow had a hard time of it. I did not know him to be the same individual whom I had treated ir the hospital ; the flush of health was upon his cheek, the sparkle of life in his eye, the elasticity of manhood in his step. He looked first into my face, and then, glancing downward, said, with a curious twinkle in his eyo } " Doctor, which leg is it 1 " For a moment, I was dumbfounded with the question, but clapping his hand upon his thigh he said with exultation : " This is the leg with which I was born, and this," pointing to the other, "is the one which Uncle Sam gave me ; " and he stepped off with only a slight halt in hia soldier's gait. One of the most celebrated of the Bridgewater treatises is that of Sir Charles Bell on the human hand. The essay is replete with thought and study, and gives the reader a true idea of the mechanism and the precision of adaptation which is found in that portion of the human body. Paly in his " Natural Theology," alluding to the same subject, says: "Let a person observe his own hand while writing ; the number of muscles which are brought to bear upon the pen, how the joint and adjusted operation of several tendons is concerned in every stroke. Not a letter can be turned without more than one or two or three tendinous retractions, definite, both as to the choice of the tendon and as to the space through which the retraction moves; yet how currently does the work proceed, how faithful have the muscles been to their duty, how true to the order which endeavor or habit hath inculcated ! " If we were to take the celebrated surgeon and theological essayist, and show to the one a man sawing wood and to the other a person engaged in writing, and were to tell them that neither of the industrious individuals was possessed of any but Wooden hands, which are nightly taken off, greased, and prepared for the next day's service, somewhat after the fashion of boots and shoes, they most undoubtedly would be petrified with amazement, if not completely stunned by an apparent impossibility. Yet modern surgery can accomplish this result. Let me give some extracts, authenticated ones, from letters written to one of the manufacturers of artificial hands. One person thus writes : " I am very much pleased with my artificial arm and hand. I find it useful in a groat many ways. I can carry a pail of water with ease. I can carry a handful of wood quite handily. I can handle my knife and fork," &c. Another says : ' ' I was fitted with a pair of artificial hands made by I. S. Drake, and I find them of great use to me. 1 can feed myself very well with them > also, can write so it can be read," &c. Another writes : "I am getting along finely with my artificial hand. I have already learned to sew with it, and can do a great many other things. I find it quite convenient at table, and, in fact, it is useful to me in everything I undertake." A gentleman from Providence gives the following testimony: "I frequently carry a pail of water, and oftentimes a basket of marketing, with my artificial hand. In walking through the streets, I defy any one to. tell which is my artificial hand." A letter from Concord concludes thus : "It " — the hand — "is a most convenient thing to drive with. 1 have driven twenty miles in the coldest day, without calling upon my other hand for assistance." Is not this an improvement upon the oldfashioned, clumsy, and unsightly iron hook which old surgery affixed to the unfortunate stump of a man's superior extremity 1 There are some operations in surgery that are dangerous on account of hemorrhage from the smaller vessels, and others which are performed by means of strangulating a part, allowing it to die and be cast off by the law of nature ; the latter procedure being necessarily protracted, and often excessively painful. A French surgeon, by name, Chassignac, being aware of these facts, devised an instrument which he called the ecraseur, or crusher, to obviate both the difficultieg alluded to. It is formed of a fine chain, gathered into a loop, which loop encloses the part to be removed ; by turning a screw the chain is gradually tightened until the parts are separated. There is not a cutting edge to this contrivance; the chain is blunt, and in its passage , through the structures so turns up oi "twists the ends of the blood vessels that hemorrhage is prevented. The working of this instrument ia truly surprising. I know of a girl, an amiable young laoy, who was unfortunate enough to have been born with a tongue so much too long thai it protruded from her mouth from foiu and a half to five inches ; she could neither masticate her food nor articulat€ a single centence ; life was kept in hei for nearly fifteen years by liquid nourishment sucked through a tube ; her appear

ance was naturally revolting, and upon the slightest exposure to cold or atmospheric changes she was well nigh suffocated by the tremendous enlargement of this congenital hypertrophy. To cut ofl this tongue with a sharp knife would have been to expose her life to danger from hemorrhage ; to twist a string around it and allow it to die by slow degrees, was a torture to which neither her friends nor herself wtfuld submit ; yet with the application of chloroform and the icraseur it was taken away, the Superabundant portion of it, trimmed to a point ; nnd. today she smgs, talks, aud eats with perfect control of the remaining portion of the organ. She went to sleep, and awoke with her jaws closed for the first time in her life, and with but the loss of a few drops of blood. The greatest revolutions also have taken place in that branch of surgery known as opthalmology, or that portion of it which treats of diseases of he eye ; indeed, the improvements in this department are so very numerous that it now-a-days constitutes a separateaiid ajiecial science. There are few physicians in general practice that understand the orthography of this speciality. How do you spell dac-ry-o-eys-to-syringo-ka-ta-kl ei-sis (dacryocystosyringokatakleisis) ? would be a puzzle for many wise heads, and its pronunciation dangerous to any but a woman's tongue. The eye, the study of which alone, old Sturmius tells us, is a cure for atheism, is perhaps one of the most marvellous constructions in nature. Its movements, its expressions, its protection, its chambers, and the great delicacy of all its component parts, have been the study of anatomists of all times. How I wish I could show to the readers of this paper one single portion of the human eye, that part called the vitreous humor ! It resembles half molten crystal in its purity and its brilliancy. And, above all, could I show you the beautiful adaptation of every structure to the office it performs in the animal economy, you would probably be lost in amazement. Imagine yourself for a single moment standing on a mountain eminence, with an autumn landscape of twenty miles in extent before you ; every constituent which goes to make up the beauty and harmony of the scene is fully appreciated by your sense of vision ; the great variety of color, the tields, the hedges, the foliage, the cottages, and the village spire in the distance, the river as ifc curves around the gentle slopes, the clouds that float overhead. That landscape of twenty miles you take in, and are able to see entire through an aperture an eighth of an inch in diameter ! Is not the smallness of the visual tablet, as compared with the extent of vision, one of the most singular and remarkable adaptations of means to ends which can be found in nature ? There are several compartments and/ chambers within the globe of the eye ; there is a curtain which divides these chambers ; there is an elastic doorway, which expands and contracts in accordance with tlxe quantity of light to be ad- | mitted. Take a candle and endeavor to look into those mysterious recesses, and you can see nothing ; and the reason is •obvious, -the raya are reflected back again, and are brought to a convergence at the flame of the candle ; in other words, the flame is the focus of reflection, and the eye cannot occupy the same position as the flame, nor see through it. iJnt modern surgery has explored these hitherto unknown and regions, and has invented an instrument by which the rays of light coming from a lamp placed behind and at one side of the head, can so be caught, reflected, and brought to a focus, that the chambers and depths of the globe of the eye can be fully and readily explored ; and the result has been that this instrument (called the opthalmoscope) tells the surgeon of today, that four-fifths of what was written and surmised concerning the diseases affecting these hitherto unexplored regions is conjectural and wrong ; its introduction has rendered obsolete nearly all that was taught by our grandfathers on the subject. How many eyes have been blinded by treatment based upon conjecture and ignorance may only be imagined ; it is well for us that no data can be found, and that forever such unsatisfactory information will be buried in oblivion. The use of reflected light, once introduced, was eagerly applied to many other cavities of the body. The intricate labyrinth of the ear, and the passages of the nose and the lungs are now carefully 1 explored ; the entire windpipe can now-a-days be laid before the eye of the surgeon. No doubt, in years to come, the obdurate peg in the boot-heel of a patient i may be found and carefully examined by a combination of lenses inserted in the mouth. But I must hasten on. The items that have been detailed as relating to the present position of modern surgery are a few of innumerable facts. The wonders revealed by the microscope alone would fill a volume twice the sisse of the " Atlantic Monthly ;" and when every week in every medical periodical some new instrument or new method of treatment is introduced, to attempt to relate them in a paper of this kind is perfectly useless. But there is a branch of surgery to which attention should undoubtedly be called, and- that is what is termed conservative surgery. Now, the rule of the conservative surgeon is to save all he possibly can, and to do away with the wholesale cutting and slashing of the older masters. In other words place as i mnch in the hands of Nature as is pracI ticable ; and it is astounding what he oan accomplish with gentle handling and persuasive treatment ! Attack her roughly, interfere with her processes, disturb her in her silent and mysterious ■workings, and she retires in disgust. The doctors, as well as the surgeons, are beginning to understand this, and the vis vnedieatrix naturce is being acknowledged by medical I as well as by surgical science. During the late war, thousands and thousands of j limbs were saved to their owners by the proper understanding of conservative surgery. One of the most distinguished surgeons of the world has lately written : — " At King's College it is a rare thing to see an amputation ; in nine cases out of ten excision should be performed in its stead." By excision is understood cut . ting out the diseased part instead of cutting off the entire limb. Let me explain a little more in detail, that the understanding of this important point may be perfectly clear. Suppose a man be shot

with a minie' ball through the shoulderjoint, and the missile shatters the bone to a Considerable extent : old surgery sees no resource but to amputate the entire arm ; modem conservative sxirgery says " Not so," and cuts out the shattered joint takes away tue pieces of bonu, and leaves the balance to Natitre ; and she, good soul ! tills up the gap with a substauca which, if not entirely resembling bone, is still of sufficient firmness and strength to allow the patient a tolerable motion at the shoulder, and a perfect motion at the elbow, wrist, aud fc'ngerjoiuts. I can illustrate this conservative snigery by another instance. There w:is once a bright, active boy, whose father was a settler, in the far-off regions of the Western country. The family were poor, but hard-working, and had come West to cultivate a small portion of land which they had raised money enough to " locate." The boy was driving a truck* waggon, drawn by four oxen, on which was suspended at huge log of wood. As lie walked beside Ins team the chain on his waggon bruke, and the log rolled over ; he ran, but his leg was caught by the heavy wood, and severely crushed, — the bones protruding through the skin, and the lower part of the leg being bent and twisted upon itself. He was carried senseless to hia home ; and there being no physician to attend the sufferer, he lay with his crushed and mangled leg at right angles with his thigh. Weeks passed away ; by degrees Nature assumed her sway ; youth and previous health, with a good constitution, sustained the boy under the shock. So soon as it was deemed practicable, he was brought — in an open waggon without springs, and through a drenching rain — to a hospital in the nearest city. There he was attacked with typhus fever, and again for weeks his life was despaired of. Suddenly one morning — a beautiful day in April — the doctor found his fever gone ; but his patient was almost dead from the terrible prostration that injury, protracted fever, poor attendance, and continued suffering had induced. God in His mercy saved him ! Life came back again — strength, hope, and above all sleep. That gentle slumber, so different from the restless tossings of feverish sorr.= nolence, refreshed him ; and he began to look into the open air from his hospital window, and feel it as with life-giving power it fanned his pale, and emaciated cheek. But the leg was still in its unnatural position, the bones were still through the flesh, the foot twisted sideways on the leg. For such a case as this the old-fashioned surgery would have had no remedy but amputation of the entire limb ; but modern conservative surgery tried another expedient. It sawed off the protruding extremities of the bones, twisted the leg to its place, put it in an apparatus to keep it the Bame length a"s the sound limb ; and to-day that boy stands, runs, and jumps, with legs of equal length, — a living monument to conservative surgery, and a. Avitnoss to the truth of the description I have giver.