, 1869-08-26
A HEw SURGICAL OPERATION.
The Recent Successful Achieve
mcut of DR.. G. d. Hcebc.
The Removal of Nearly Five Feet Of
Human Intestine.


| .
How 1t Was Done.
An sccount Of remarkable surgical operation
which appeafed ID TIE TK1HCNx Of July -, nas
Stren rise to 80 much tnc:rdnlous inquiry aaa
comnuen that We hAve tAken the trouble 70 oo&ain
frou ps. Beeoe the particulars Of the operation,
which NC here present In his DEE language 1t
Will be espec:ally Instructive to the 6nEs1ci pEo-
1csslou, and no. without interest 70 the general
yraler: |
July 10, 1872, I WAS calied to sec Mrs. J. B.
Chlda, Of Lee Centre, IL. who IVES temporarily
IN our city for visit and *naa It
the house OF f7crd w17 taken
with 1aost violent pin In Al nnoin-
esl hernis, which naa existed since severe
iaoof seven years previously. foaad tie 73tie7t
OF dark complexion, ssoat b7tit, aged about 70.
No evacuation Of the bowels had occurErf for
week The violent pstn hsi begun three daJs
before, soon followed ~ vomiting, which, during
the last twelve hours had been stereosAeeous, WILL
fre11ent disposition 10 stngultns. On eIasana-
uon large tunor was found At the umo!iicus, tao |
thin integumenta1! coverings Of whicaHcrc Cre3ly |
dtseo,ored, and we're on the point OF JIeid.ng 10 |
the pressure Of = considerable quantity Of dutd |
therein coutStnei The skin and pulse did not H.
t,ea.e auy marked per1toueal inflammation, bat
"~%1@
already n appl5tug proper Treatment "!:nous
detsy the tntcccnents wrsc carefully tncacd, aud
TWO or thfee ounces Of bloody st1uu eAcsped.
The o,Actened n.estne vxs now visible at tae
| opening. and with d Hrpoved dtrsctor the
Aern.A sAc was freely laid open. when :;
Was startled to 1nd 80 much Of the Intestine e.
1ruded and the entire uass rot only 5lace with .
d,scofors,lon but at points Jteld,ng End permit
| tlng the escape Of fecA matter. rac sit1st4on
| wAs novel md. 80 far - could then Focap 70 i.
| ueruosy, without precedent, b1t + nouauia rs-
nee,ton satladed TIC that the patients CHANGES foE
| life lay In removing the IeE!tailzed tissue. and
pursuing such further srers Is would aabjccs her
| TO the leAst hazard possible under the cuclm-
| STANCES l can strongly commend the use OF
| Leuherts sutu1e IN all cases admitting inuc-
dlate union Of the extremtles OF the intestine
hut IN this the extent Of Intestine u ba re-
moved seemed to suggest greater hazard Ii S.
tempting to lotn the divided ends Of the gu- BY
sutnre than IN establishing An artificial Anus and
eeec,irE cure Of this artificial opening so soon
a. the Immediate dagger from the ats: operation
nad passed. therefore determined upon the
latter coursc, aad, With the assistance
Of two or three Of my medical col
| leagues, whom I could hastily Summon
10 my aid, having t,uced the gut to the hern!al
ring, and finding sound tissue there dlfttled It,
aru passing strong zuturt secured the soond
extremity to the margin Of the inclsion* Then,
with pair Of Acazsorz, tEe Intestine was cut AWAY
from thc n,e4enterJ throughout It's extent until
: Found in,cstlna MAS fuunli At the opposite side
Here II WAS again divided and tho sound extremity
= ! ecrurcd ntc the former.
: The uekeuterlc yesSels which werc vefy Miner
: ons As mar be Inferred, gave rise so pretty
s11s1t heuorrhage at nzst but shcae vessels "ese
closed by tosson aud ~ the application OF ice
0 ultil al bleeding had ceased, when the hern!a
J knife WIS brought to bear on the ring, and tnts
!! was sufficiently enlarged. Making sure that the
. / bleeding did not rccur on the removal OF Inc
pressure which hai been Esa!nta!ued by the rins,
9 the parts were returned within the abdomen,
! 1eay1Lg the two dshlea ends OF intestine Pro
! ty1utng from the abdomen anti 1sin9 s'ac
G | by side where they were secored 10 the intego
n,enta,5 margin tJ su,ufea oi silver wire IN such
:: manner a. ta form Al artificial nnus. During al!
= this procedure tic patient YES quietly sleeping
l. under the influence Of ch1oroform, and u!an!
here adA that having thoroughly tested aulphus1t
= ethcr ether and chlorofor1n mixed, and the nors
~ recently discovered blchloEidc OF reihTeue,
10 have no hes,aton tn saving that slu!oos pnzi7c'
o choroform L., IN nj op:1.oa, the NOS: desiF1bs
auastne,tc known, both as regards efficiency an
tatety OF administration.
Dus!u. the twelve hoIEs following this opecs
ton the cathA,tcs which had been freely admir-
1sterrd bJ my predecessor IN the case, were be!n
pouredout III the artacIa oreItpg. and there vas
LITTLE disposition to siugu1tus arm some Vomiting
a. rect the gastric irritation present, and IN aatlcip
~ ton Of per!tonea Inflammation. Daring Il
y y day following the operation, the pulse rose
- | 1s0, una there was considerable tcu1e
.A | pe;s Of the abdomen but To tynpanItes Afs'
cd the lapse Of foryeght hours this Irritation btgs
"a "a to euhside the pulse dropped teloH ~, au sot
AZ had The satisfaction to no:e The rtiuEn of rru'
si, for food and OF comfortable sleep. II VAS fout
necessary to exercise great care In dieting the p
+kn JhnHtA nt nit
he being altogether 1utd, rAned greatly Wlth
Iat ehaugea In diet potato aud some other As1cl
hn OF food producing keen N ac1lttJ ~ quickly
"a destroy the c1ucie with which lacy came IN CO
-; tact Beef tes, prepared By the following tormu
re- xas made the STANDARD article Of dles In Il
ey case, the mtriAiic ac!d gE.aslJ promoting dl,'
nS tion and assimilation: Lean bttet, cut nne, or
81 q. hau pound; cold water, twelve ounces; taoe IL
ter one teaspoonfui; pure nu1ia,lc acid, four dtpl
f3s This to stard Two hours IN = covered d1sa, a
A tlep, being strained, Ii ready 70 SIRE. This pEe
~ arat!op, always well borne b. It'd most eEns1tt
stoaaeaB, SEEMED Particularly suited 10 thas ca
md | aud The lestatuns from this we're more " way
MY experiment. to test the digestive powers OF
. .Re stomach and duodtnuu. 4 Inc deld HAS ht
presented 10 the ply s!ologst 10 note the coulplt
do OF partial digestion af dil1elent Ailments oI
stomach and duodenum, with the upper poE1t
~ 70 Of the jetunun; but upon this Geld We GAIL
~, nn- now en1cr An examination of tho Intestine
ptu HQte0 AhQNb1 II W G5 lAlly !Ull teek LE4A As4
y II In length, and TO belong to the. 1ejunurn.
cen With The rc.e5talisaMent Of sha uEcstl
furrt.opR and the suhaldeace OF the in1amma
n sJnptous attendant UPON ihe 0Fst oi'eTau
announced II. intention to operate iminedlst
tt.t fer tac relief OF tho aztlteA Aus Here found
b.s necessary TO depart from tie !lna OF eataolss
ariy precedent, and there were ros wantn; those In
III profession Who with the authos. thought this Of
erai alton should have been delayed for Several mon
| h7S m
tuat for delay, and 10 SOON "a the proper iostume
5 20 could he made from drawings, Was read5 10
10 cecI. 4 few days delay E4s asked h the
vii ttent = husband On account Of his business,
$ then, On July 81, the patient being fully aua.4
TIC tiketi, The ext1emet,es Of the gut wese explo
~ 10 determine their course Oh entering tue y
ner men, the presence of adtesious, and the r
CO tuut al otncs yl,cera- 4 chimp four iac
Enc in length. the tlnlies Of which y
tn. oval ,hreeforEths Of an taeh wide, By one
fhe | End onelourta N length, and feustratrd 50 .
.tc Itaye scEratcd Jaws o1eeisn,h Of An lnch :"
laey WA then introduced, one bInda being passed
su.a each rrotrudlng intestine u0r1 fully within
&c aotolen. 81 the ttasr-Io.nt, q: the outer
.oad | TRINITY al the hardles, tho hla6es were
.lde- locked, and the setscrew introduced. Great
IaJ xas exercised that only the Intervening vail.
Icy theae iutessncs should be embraced hJ the cla
this | aud the blades we're then appro1lEated. b.
dry tet screw In the handles. uniu slight pain wal
~ | c343ueC 4-s-tuSktuA2 NC4C H4sEA *o7% II 0fA.
j n and vomiting ocr11ed, the clamp should
oala tishIl5 !oose1eI Otherwise It should be g7aa1
In i ,sghtepca dunn9 the next two dAJE+hs OF
q s9 OF this pressure being to cause degree Of =
~ - gye Inflammation Sufficient 10 unite these i
unts. When, on the third d4J, The presHmp
being that this Ind occurred.
.st-I p.rsscrr Was applied u the csaap
tae purpose Of destroying Tho +
between the b!aics, and thus make an ope
!. l. frpta Que intestine through Into the osaef.
mau nate tbs the more entctua1, a free lnclsion
IL made hy means Of Z gan lancet through
ores feDcs,zal opening IN the b:adcs oi the clamp
bctn the fourth 11y the Cs2Lp Fhs ET64u1u3 looHt
4: "a aud Withdraw. while = 1sTu compress VA.
SAME | u,...,h. .,,,r,,., s,,, Thu fowar hn,
hua9 pHeo ~ ~ .ue - :, 80 1a, ..,.,,1, ~,
much iAtn entirely !caetye for foat weeks, nnF b
oc 10 exhibit activity, and from this time the re-
tAX | dati. excavations OF the bowels occurred b,
eary rertum Of character a euttret! uoT:ual u
creed which characterized her previous eooe!:lo
t1tb'5 heslth. indeed 4 former habit Of eoas.pi
neSt seemed 10 have been wholly scmorcsl. d
mresi examination Of the point II which The clamp
astef app1et revealed the smooth rounded eds'
II Of the opening produced By The Instrument
ieaen now onlF remained 70 close the iEteEurnct
-nad oper,pg OF tho artificial anus, which VIA dor
Nor August +, by deeply set quilted surnes Ct 8
a.ins wire and the patient returned 70 her homo
# !oi- cer,1al pa1r Of The State. leaving ny cshne
Tched hy ! pathological specimen which
uA1 highly prlzed ~ It - !asc-
~ ~ THIS c4te Is, peTh3ps, without parallel
tae3~ records Of surgery Il feE1rtt thc amount
'se~ ae testnc lost md the ilonediasa relief a1I