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

i
FIRST LECTURE OF THE FALL COURsE-DR CARNO-
CHAN ON NEUTRALITY-SUSPICIOUS. OF THE SUB
| IECT-MILITARY SURGEONS IN ATTENDANCE, ETC.
The nrs OF the fall course OF lectures Of the New York
Medical College was delivered on Monday by Professor
Carnochan before . numerous audience in the amphi.
theatre OF tho institution East Thirteenth street. Tho
subject selected for the with peculiar
importance at this time from the fact alluded to by
the learned lecturer, that destructive is being
waged In midst, aud It, therefore, became the mpe-
ravo duty Of all young students to prepare themselves
treat successfully the dreadful casualties which must
arise hereom To the military medical studensespeciay
this a subject for inquiry and study as
upon the of his professional knowledge much suf
ferng or alienation Of suffering follow to the victim
| OF the battlefield.
Among the audience on Monday several medical
men In uniform, denotng that the invitation extended to
them through the HERALD accepted in the spirit in
which II was gven--that of sympathy with brave
soldiers who may be manned the field OF battle and
for whose succor we would in the best mefcal
aid That our army Is attended by able and competent
medical men there is little doubt and gratifying to
see those young men who have not yet gone
| no opportunity or acquiring Information to fit
than for a faithful discharge Of their humane dntcs.
The lecture was entirely Of practical character All the
appliances for Illustrating the different points OF the dis
course were provided. Tho lecturer assisted in his
operations by three Of the students of the Institution
Or. Carnochan, after the applause which greeted him
had subsidized addressed his audience folows-I have
been requested by colleagues to open the preliminary
course of lectures in this Institution for the present
son, and the Of the Faculty offer congratulations
to those gentlemen who reappear after the
tion as well rs TO those who, for the first tme pre-
sent themselves for the purpose Of prosecuting their
| studies Tie exigencies Of the times appear
| to require special attention to some branches
or the healing art and more particularly 10 the depart
ment OF surgery Tho extensive muilaon OF the battle
field often demand the sacrifice Of more or less portions
Of the human mechanism in order to the rest from
obstruction IN civil lie also, ON account OF the acct
dental LESSONS or morbid growth, other pathological
conditions the surgeon is obliged to perform the opera
ton Of amputaton or the removal of part from the
body which is no longer useful to the general economy.
1t is only within comparatively recent period that the
operation Of amputaton has been performed in suitable
or proper manner Up to so recent time as the six
tecnth century, surgeons were afraid to ampGtato
| through parts which were not already mortified
| or dead; or, If venturesome enough to cut
| into the living tissues they had resources
| with which to arrest tho hcmorrhage but by
such painful applications the actual cautery, heated
OIL or boiling PITCH into which the sumps OF the unor
tunae patient were dipped We are Indebted to the "a
nous French surgeon Pare, who nourished about the
year 1852 for the invention or adoption OF the ga-
ure upon the arteries in Order to the bleeding af
tor amputations and thus was laid the foundation Of
that degree Of perfection which this class Of operations
has acquired up to the present time. The operation OF
amputatng though crude, is requiring great care
and adroness; for upon the manner in 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 recourse to
| the knife.
For the clear exposition of his theory the lecturer
first divided the subject Of ampuaton into two classes
| said, were conventional terms. The first applied TO am
putaons when the bone Is cut through the other TO
cases where amputaton is performed through tho joint
| There were four methods of performing amrutation.
These were designated IN the college the circular the
ncsion with one Zap, The ncson With two flaps, and the
oDlque or oval. These different methods had their own
particular advocates and followers The great object
in the operation to have sufficient coverngor
the bone to prevent any excavations from foreign
as was supposed, and indeed, it with
the view of rendering this part Of tho
Qftrpt If
geons had adopted changes from the original method The
difficulty arises from nanmatory action Selling upon tho
tissues sometimes from the convusive action of the
stump itself frem too great suppnraon, 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 practtion
! ers disagreed military men favorng an immediate
operation There shocks to the system consequent
upon these severe accidental injuries which demanded
consideration. IN some cases collapse is manifested.
There We're again instances where tho system failed
| to sympahzc to any great extent. This is generally
the with gun shot wounds which at first but
little sympathy of the system but then the result always
shows that reaction takes place III about forty eight
hours after the n1icton Of the INJURY and high
| OF niammatory constitutional fever sccceeds There
were some good reasons for the position assumed by mill
tary surgeons, that an immediate operation gave the
patient tho best chance The fact of these wounds being
received the battlefield almost necessitaes immediate
operations account of the difficulty of conveying the
patients Il the field There are rough roads ami rougher
fields and by ways to cross and the patients subjected
to painful and dangerous jot gs Then, indeed the pri
mary operation, rs ii was called, necessary. In
| civil lite 1t 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. Amputatiors with ree-
renee to time divided into primary, the inferno
date and the tertiary For himself the lecturer said he
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
system in those loses the power Of receiving
impressions, and cannot be influenced by the operation
Particular stress was laid upon the Of chorororm.
This, when applied had depressing influence, and FIRE.
Guenty patients had died from being subjected to in
| luence. II dangerous to choroform at time
when tho body was already tending TO state Of collapse,
In these cases he must soy he would leave choroorm
out except indeed, when the system still
susceptible The lecturer then proceeded to impress upon
his younger bearers the necessity of bairg always fully
prepared for any emergency for any accident that might
arise in the Of the operation Every thing n,ejl
ought to be placed that the operator could himself
take up the article he wanted Assistants ought previ
| Osy to be well informed Of all that expected Of
themthe nature Of the operation, and the and
degree of assistance they were TO render The relative
| positions Of the operator and his patient also
described. The preliminary preparations such
| the examination OF the Instruments the applica-
| ton Of the tourniquet, the Of which was
nothing necessary and the scrutnzng glance to satisfy
himself that thing was in its place and ready for
All this having been gone through the lecturer then
proce eded to the Illustrative part Of the subject
double amputaon was performed: enc according to the
circular mode of incison the other according to tho
double flap mode. Tho manner OF manipulating and hold
ing the limb treated on, and particular attention
called to the manner of using the sharp Instruments.
The operations performed with great dextery and
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 tho lecture
| SHOALS OFF NORTH CAROLINA.