The New York herald. [volume] (New York [N.Y.]) 1840-1920, 1861-09-22

New York Medical College.
FIhsT LECTURE OF THE FALL COURsE-DR. CARNO-
ohAN ON OBSERVATION-DISCLOSURES OF THE SUB
HCT-hILITARY SURGEONS IN ATTENDANCE, ETC.
Tho nrst Of the fall Of lectures Of the New York
Medical College delivered on Monday by Professor
Carnochan before numerous audience in the amphi-
theatre Of tho institution East Thirteenth street. The
subject selected for the occasion is invested with peculiar
importance at this time from the fact alluded to by
the learned lecturer that destructive war Is being
waged In midst, and H. therefore, became tho mpe-
ratve duty Of all young students to prepare themselves 10
treat successfully the dreadful casualties which must
arise thererom To the military medical
this subject for most earnest inquiry and study az
upon the extent Of his professional knowledge much suf
ering alienation Of suffering must follow to the victim
OF the battlefield. ss srs 80 &. trf
Among the audience on Monday were several medical
mon in uniform denoting that the invitation extended to
them through the HERALD accepted in the spirit in
which 1t was givcn-that of sympathy with our brave
soldiers who may be manned the field OF battle and
for whose succor we would fn the best mefcal
aid That our army attended by able and competent
medical men there is little doubt, and 1T is gratifying TO
70 the seat Of war. exhibit desire to lose
no opportunity OF acquiring Information TO ut
than for faithful discharge of their humane duties.
The lecture entirely Of practical character All the
appliances for illustrating the different points OF the dis
course were provided The lecturer assisted in his
operations by three OF the students Of the institution
DR.. Carnochan, after the applause which greeted him
had subsidized, addressed his audience folowsI have
been requested by my colleagues open the preliminary
Of lectures this institution for the present
and IN tn, Of the Faculty offer congratulations
those gentlemen who reappear after the SKINNER
ton as well es TO those who, for the first time, pre-
sent themselves for the purpose Of prosecuting their
studies. Tic cxigences Of the times appear
4 70 require special attention to some branches
the healing art, and more particularly 10 the depart
ment Of surgery The extensive mutlaon Of the battle
field often demand the sacrifice Of or less portions
o. the human mechanism in order to save the rest from
destruction. In civil lic also, on account OF the acct
dental LESSONS or morbid growth or other pahooscal
ton Of amputaton or the removal of part from the
body which s no longer useful to the general economy
II Is only within comparatively recent period that tho
operation Of amputatcn has boen performed in suitable
or proper manner Up to so recent time as the six
through parts which were not already mortified
| or dead; or, if venturesome enough to cut
into the living tissues, they had no resources
such painful applications the actual cautery, heated
OIL or boiling PITCH into which the sumps of the unor
tunate patient dipped We Indebted to the "a
nous French surgeon Pare, who nourished about the
year 1882 for the invention adoption OF the lga
ure upon the arteries in order to arrest the bleeding a
ter amputations and thus laid the foundation CT
that degree Of perfection which this class Of operations
has acquired up TO tho present time The operation OF
ampuating though crude, is requiring great care
and adrotness for upon the which it is per-
formed most frequently depends the life Of the patient
In other words the patient may die from the operation
and not from the injuries which demanded to
| the knife.
For the more clear exposition of his theory the lecturer
first divided the subject Of ampuation into two classes
one of continuity and the other Of conguiy These, he
said, were conventional terms. The first applied TO
putatons when the bone is cut through the other
where ampuation is performed through tho joint
| There were four methods OF performing amputation.
These were designated in the college as the circular the
incson with one ap the ncison with two flaps, and the
obque or oval. These different methods had their own
particular advocates and followers The great object
secure in the operation is to have sufficient coverngfor
| bodies. This was not easily performed
| tha .xaxv of ranHo~t mart pf tba
operation more easy of attainment that celebrated
geons had adopted changes from the original method The
difficulty arises from namatory action Selling tho
tissues, sometimes from the convusive action Of the
stump ITSELF from too great suppuraon, and from gan
creme attacking the margins Of the flap Great should
be taken in selecting the time for tho operation On this
point the lecturer said that military and civil practon
| ers disagreed military men favoring an immediate
operation There were shocks to the system consequent
upon these severe accidental injuries which demanded
consideration. IN some collapse Is manifested
| There We're again instances where tho system failed
to sympathzc to any great extent. This is generally
the case with shot wounds which at FIRST but
little sympathy of the system but then the result always
shows that reaction takes place in about forty eight
hours after the nicton OF the INJURY and high state
Of infammatcry constitutional fever s:ccceds There
were some good reasons for the position assumed by mill
patient the best chance The fact Of these wounds being
received the battlefield almost necessitaes immediate
operations account of the difficulty Of conveying the
patients f the field. There rough roads and rougher
fields and to cross and the patients are subjected
to painful and dangerous jo gs. Then, indeed the pr
mary operation, as it was called, necessary In
| civil lite it was well to give patient the
| benefit Of time, for there is always better
chance of surviving the amputation performed in the
condary Intermediary state. Amputations with refc-
renee to n,e divided into primary, tho ntermc-
date and the tertiary For himself the lecturer said no
believed that in sudden injuries the habit Of waiting for
reaction on tho system Of the patient was too prevalent
Patients have frequently died from this delay Tho
vous system in those loses the power Of receiving
impressions and cannot be influenced by the operation.
Particular stress laid upon the Of chloroform.
This, when applied, had depressing influence, and fire.
quenty patients had died from being subjected to its in
| nuence. II dangerous to use choroform ct tno
when tho body already tending to state Of COLLAPSE,
In these he must soy he would leave chorcform
out except, indeed, when tho nervous system still
susceptible The lecturer then proceeded to impress upon
his younger hearers tho necessity of bairg always fully
prepared for any emergency for any accident that might
arise In the Of the operation Every thing nedul
ought to be placed that the operator could himself
take the article he wanted Assistants ought previ
o.sy to be well informed Of all that expected Of
themthe nature of the operation and the nature and
degree OF assistance they 10 render The relative
| positions or the operator and his patient were also
| described. The preliminary preparations, such as
| the examination Of tho instruments, the appca-
ton of the tournquct, the use Of which
also described, the caution to tho assistants to omit
nothing necessary and the scrutinzing glance to satisfy
himself that everything in its place and ready for
All this having been gone through the lecturer then
proceeded to the Illustrative part Of the subject
double amputaton performed che according to the
circular mode Of ncsion, the other according to tho
double flap mode. The manner of manipulating and hold
ing the limb treated on and particular attention
called to the manner of using the sharp Instruments
celebrity and ELECTED the applause Of the critical audience
who throughout paid the deepest attention to the words
and operations Of the lecturer This closed the lecture
SHOALS OFF NORTH CAROLINA.
TO THE EDITOR OF THE HERALD.