The Portland daily press. [volume] (Portland, Me.) 1862-1921, 1871-11-03
Dr. Robinssn's Case,


compelled to rep v TO some statements therein
maue, and to add some others which do not ap-
pear, and which seem necessary to a full un.
uerstanding OF the whole matter. At least one
| .niru OF the entire article is devoted to vague
Inquiries and insinuations as to where the first
| grave doubts" came from. In reference to
TINS matter shall only say that "one in con-
suitatlon disclaims any knowledge OF how or
from whom such grave doubts" bad origin /;
and do not understand why the writer should
have been actuated by sueh motives as led him
to make such unkind and unjust insinuations
Ii was ever actuated by motives purely I'M
selfish, and if 1 ever sought earnestly to know
what could do for the relief Of a suffering fel-
| low being il was in all of my relations with
this case So far as the benefit to the public is
concerned, think that may safely sag that
he who seeks to benefit a single member of the
| public eeks to benefit all. And as to the pro-
fession it ..ay be said that he who labors to
| benefit it, benefits himself and receives from
| the profession important lessons. Now the
| gentleman who comes out over his own sigma
ture may receive an important lesson from this
interchange of views through channel
which msy not be strictly appropriate and le-
| gitimae though tits one OF his own choosing,
and that lesson is this: Never rush into public
with sentiments until you are sure they are
correct.
To DR.. Wood, then, are we indebted for the
| prominence that this case has assumed, mas
much as he admits he called upon the "coure-
| GUS editor of the Argus" and gave him a his
| tory of the consultation, and furnished him
with the material to make the statement that
| the council were unanimous i'll the opinion
| that the amputation above the ankle was i'm
perative in order to save life" which be asserts
is literally true. Now in order to have ones
| opinion in consultation of any value as against
| majority, if it is necessary that he withdraw
| from such consultation or else =" heartily con-
| cur with the majority, then indeed the minor
| ity in this council did concur and the opinion
was unanimous one; but if an opinion given
| 10 deliberate and positive manner by ore
| member and urged and argued by another
| an equally positive manner, aud which opinion
| was never in any manner changed, modified or
restricted, but against which a majority acted,
| then the council was not unanimous so far as
| my opinion was concerned. Such is the fact
| and deny that under any existing circum-
| stances" did "advise or concur in the opera.
| ton )" neither did the one whose opinion coin
cided with mine. fully agree with DR.. Wood
that it was necessary to go high enough to EN-
| sure vitality" but when nature has shown by
| granuations where she can nourish Gas was
shown in this case before the operatiOn) it is |
necessary to amputate eight or ten inches high
| er in order to save life? co not believe this
would be the unanimous opinion of all or any
| of the best surgeons of the country-"unani-
| nous in tie consultaton!' What led Doctor
Ludwig to make the remark that it was a pity
| we could not all agree and recommended that ,
DR.. Weeks and myself re examine the patient, .
alter the relative merits of the different opera
| tions on the foot, of Chopart and Symes, had
been SO fully discussed by us, and advised that
it should be well considered before SO severe an /
operation should be made as the sacrifice Of |
the leg? OF the two operations named, Dr. |
Weeks was the first mao to allude to Them |
When my opinion was asked, being the last, !
L think, but THREE of the ten in number, did |
say was in favor of Chopart's operation, aud /
remarked that nature had already nearly per- /
formed it for us, and the remainder would be |
very simple to do, and that-it would hardly re-
quire the use of ether, yet would advise it in |
this case as the patient was SO i'll prepared to
bear any additional suffering. y
This OnuiOn i advocated earnestly a I
deemed consistent with professional courtesy !
and harmony in consultation. Dr. Wood says |
mot one word was uttered at this consultation |
of an unpleasant natuTe-the procee dings were |
entirely harmonious" To whom does the |
credit belong for all this appearance of har- |
nony in consultation? Is it due to either of |
the two senior members of the council who |
assumed to lead in the consultation aud so ar
deutly advocated the amputaton of the leg, /
and after had SO fully expressed my views in |
favor of the operation on the foot only, one of |
whom uttered for personat~thrust that mo |
fancy operations should be allowed in this !
case?" 1 appeal to the members of that coun-
Gil, and am assured that = majority Of the !
members will declare and say that at the cou- /
sultation and operation the following day that
was diScourteousiy treated and openly insult
ed. Not a suggestion did 1 make which was
not opposed, nor the most trivial recommenda-
ton as to the formation of flaps, use of stitch
es, dressing, &c, even after [ had been asked
by the operator to assist lin, nothing was
offered that was cot most stu1i,usy and con-
temptuOusly re jtcted. Yet with all these facts
the "proceediDes were entirely harmonious
and not word WAS uttered Of an unpleasant
nature" The mex. morning "une in cOnsulta-
ton very kindly volunteered his valuable
services This state me nj il simply false. At
the close of the consultation the day previous
to the operation, DR.. Small. who was very
properly selected as tie operator, said to me,
II want you to be present Tomorrow"
obeyed his request, and was at the house
promptly at the hour assigned After the pa
tient was etherized and the necessary prepare
tons made, We were sent for to go to the oper-
ating room. On entering the room DR.. Small
beckoned me to come to hin. did so. He
then said, Il want you to assist me-" and
called my attention to thu form Of the flaps
that had previously been marked out on the
leg at the point where it was to be amputated.
These statements DR.. Small will now
confirm. did render him all the assistance in
my power in accordance with bis request, but
was at the same time a victim" of grave
doubts as to the propriety of the operation per-
formed. Could have refused?
Now as to the arteries. There were
two instead of one artery that vouch-
safed to guide one in consultation in
the performance of his duty" and he aided in
tying them. The first was the posteIior tb-
ial. and the second the interossute. The for
mer was first sought for and secured, and gave
as much "spurs" as is usual, under the eircum-
stances and conditions that existed. What are
the facts? DR.. Robinson has for years been in
feeble health and for the past four or five
intense agony and unable to take nourish. |
ment, consequently, anaemc and emaciated ,
and his blood reduced both in quality and |
quantity. This condition alone is enough to |
account for the feeble squirt of an artery. In !
addition to this the tourniquet and three able !
assistants been exercising more or less pres |
sue O q the arteries above, and one of the
| sistants making direct pressure at the thigh:
Furthermore DR.. Wood should know and |
would have known had he had much expert
ence III amputatioRs of the leg, that this opera
tim is frequently made and none of the arte
ries require a ligature, even in a full blooded
and healthy person following accidents-This
occurred ia my own practice within the past
year. There was nothing in this case Unusual
in the 'spurJ" of the blood, or appearance of
the arteries, they were all dissected out after
the operation, even to the sole Of The loot and |
found to be 10 a normal condition. Rarely are |
more than two arteries tied in this operation, |
even when there is the normal distributiOn.- |
They vary much in different persons, both in |
size and situation and oitentmes some OF them |
are entirely wanting. These facts every sur |
geon of ex perieDce IS familiar with. DIR. Wood |
in his editorial communication in the Argus of |
the 18th OF October, and also the one In tho |
Press-has taken occasion to refer particularly |
| TO DR.. RobinsOns opini0n,-to sustain him in |
his theory, that the operation should be made |
| above the notwithstanding at the same time
that he was an eminent surgeon and in the |
| full possession of his mental faculties &C.
That DR.. Robinson is an eminent surgeon and |
| physician, and ranks among the highest in the |
/ Stat6-l most heartily endorse. Inab ne was
10 the full possess of his mental faculties l
| do-wth all res pect to him-most empbatically
| deny. In God 5 name can man be in full
possession of his mental faculties when he has
been allowed Tor mouths past to take that
which is equivalent hundred to three hun
dred and tlUenty grains Of opium per ddy!-
| crowced into his stomach and FORCED into his
| system by injections, through channels which
| could not be rejected! Ii any one could have
| witnessed the scene dd-on visiting him a
| few weeks previous to the operation, not being
| able to compete sentence without losing con-
| sciousuess, then at times wild and frantic, his
| system SO pcisontd that almost every function
| was suspended perverted, not able to bear
| hardly the slightest touch upon his skin, cur
| rent of air even, giving him shudder that IL
| most threw him into bydrophobc spasms, they
| would curse the drug that was then destroying
| both mind and cody. Can any man take this
| amount of opium daily AID be in possession of
| his full mental faculties? If not, where lies
the responsibility? Is it strange that for many
long weeks that an awful struggle should ex-
| ise between life and death in that poor mans
| foot? Answer who can!
| In the consultation DIR. Wood was, as he bias
been from the first of DIR. RS illness, the con-
trolling spirit, and spoke in his usual positive
| manner as one having authority, and was
| obeyed. Upon him, therefore, moro than upon
any one else rests the responsibility, and be
| should assume it, and not the Unanimous
| cou ncil somc of whom had ''misgivines" even
if he had none. Dr. Wood further says: "The
disease had invaded the bones of the ankle
| Joint OF all of the statements made, this Is
| the most startling The truth is this. In
proper time after the operation was made,
Il 81 mi ,afI