New Orleans Republican. [volume] (New Orleans, La) 1867-1878, 1874-08-09


The method applied only to simple frac-
lures. Compound and cOmminuted trac-
lures were Q different matter altogether.
The first case Of a compound fracture that
was treated on the application of this new
principle was that Of John Schiller. He
was taken into the Park Hospital on the
second of February last. He had frac-
ture of the large bone of the lower arm,
the end of the bone protruding from the
wound, fracture of the bone Of the upper
arm and two fractures of the small bone OF
the lower arm. This made four fractures
in all. The usual method of treating
compound fracture of this kind has been to
lay it in tin splint upon pillow and stuff
oakum about to absorb the secretion. This
scalds the skin, and the arm must be
moved frequently to change the dress
ing This motion ia very unsavorable
to good union of the ends of the bone,
ard the skin soon becomes sOdden and de-
stioyed. The object to be attained is per-
feet rest, freedom from that irritating
secretion. and opportunity to dress the arm
and examine it without moving it. One
morning when the surgeon was dressing the
arm Schiller remarked, doctor, my arm is
smoking" Every movement caused ex-
quisite pain, and DR.. Fluhrer determined to
apply some apparatus by which these diff
culties in the way of recovery might be
obviated. A pulley and suspensOry appa-
ratus was rugged, and many of these points
were gained. BY continuing bis expert
ments, Dr.lFluhrer at length attained a per-
lection that msy now be considered as the
true treatment for compound fractures, as
his method of preserving the line of, con-
tinui.y that was SO fav0rably looked upon
by Billroth In Vienna has proved for simple
fractures.
When Demsey decided not to have his
arm amputated, DR.. Fluhrer, recognizing
the many complications that wonld arise,
thought OF still greater improvement, and
applied the apparatus To his arm. An up
right post was erected at the head of the
bed. from the top of which ran piece of
small iron gas pipe like a crane, terminating
in hook bent upward. From this crane
was suspended small iron pulley that
could be run back and forth, the hook at
the end preventing its slipping off. Next
from the pulley ran piece IF rubber tubing
about eighteen inches long. This was to
prevent any jar to the wounded limb when
it might be moved. To prevent any
possibility of an accident by the break.
ing of the rubber tubing, piece of iron
wire was attached, which would save the
lint from falling more than q sixteenth Of
an inch. Below this tubing q chain ran
down and hooks were fastened into this by
which an iron frame was supported the
length of the arm. A mesh of bandage was
made from one side to the other in this iron
frame, aud in this mesh Demsey's arm was
laid. The entire front of the arm was ex.
posed to sight, besides the wound from
which the bone prOtruded when he entered
the hospital. The mesh was opened, so that
the terrible laOeratiOn behind could be
treated without moving the arm, and all
the secretions could run off freely, leaving
the skin clean and healthy. Should the
cnr uinh fho dives
another frame is prepared with q mesh
of bandage and laid under the one on
which the dressing has become sOiled. Then
the hooks are changed, one at time,
and the new frame is made fast. The
mesh on the old frame is slipped away with
SCISSORS. and the old frame is removed with
out stirring the arm at all. The surgeon
asked Demsey one day whether he had had
clean dressing that morning. He replied,
"Well, doctor, the arm is clearly dressed,
but was asleep and didn't know when they
did It," Under the old treatment the pain
and trouble of frequently changing the
dressings would have kept the patient in
fever and materially lessened his chances of
recovery. Now Demsey can move about,
get up aud sit in a chair while his bed is
being changed, and all without even Earring
his arm. He would certainly have lost his
life if he had been treated by the old method.
But nnder the advances of medical science.
Demsey will t'Only recover, but his right
arm will be as good almost as ever and he
will be able to do good days work in two
or three months.
johnny Jordan, whose elbow was terribly
crushed, also in printing press, is now at
work again, and his arm has become so
strong aud sound that he can lift nearly as
much as ever with it. Another patient
Henry DENY. was admitted into the Park
Hospital on June 81 with a compound frac.
ture of one foot and a bad laceration of the
other. He had been run over by horse |
car. DR.. James II. Wood decided that the |
feet must come OFT, and DR.. FIuhrer ampu- |
tated one by Syme's operation and the |
other in the middle of the leg The legs |
were then suspended in the new apparatus,
that enabled DENY to sit up and move |
about without stirring the wounded stumps. |
He made such rapid progress toward re-
,overy that he was soon permitted to get up |
and move about on crutches. In the or
iinary treatment he would not have been
able to move for at least tour or five weeks |
more. But, by the apparatus that kept the
'tumps immovable, and permitted change of
position Of the rest of tho body, the condi-
ions were present for rapid recovery.
One of tie greatest advantages and most
results gained by DR.. FluhreI's
lew method of treatment is the entire alb.
ence of dec0mpOsing fluids and acrid eecre-
ions that eause the diseases that make hos
,itals charnel houses. All secretions are at
,nce carried away, and hospital ward
where the new treatment has been in vogue
S utterly free from py amia. A man named
Manning had been treated for a compound
Iacture of the leg, in the Park Hospital,
~ tine old method of fracture box, in
which the leg was bandaged and pillowed,
utterly hiding it from sight. Erysipelas
vet in, and the amount of secretion was
10 great that the dressings were saturated
Il short time. 1t was necessary to move
he leg to change the dressings twice
lay The secretions had scalded and irri
ated the skin, and at length the whole
kin and other tissues were peeled off
~ the handling. Carbolic acid was poured
nto the fracture-bOx to disinfect the Sc
reted fluids. But the case grew worse, and
worse. On June 25, DR.. FIuhrer took the
eg out of the fracture box and suspended
t by his apparatus in the usual manner.
Then Manning had delirium tremens. But
le began to improve rapidly. The entire
eg was open to the atmosphere, and the
ecretions were drained and carried away
without injuring the skin. Manning is now
'ltting up. and, instead Of his life being in
great danger, he is rapidly recovering and
will have sound leg. Owen D0wney was
'un over by a street Car which he was
irving, and his leg was fractured badly,
he bones protrudiug. He was admitted on
Nay 30 last to the Ninetv-ninth street
Hospital, and placed in Dr. Fluhrers appa-
'atus. He had erysipelas, but suppuratlon
lid not follow, and he went on toward q
'apid recovery, though he had been very
Incorporate man. He is now up and out
IN the balcony of the hospital with only
Gather split upon the leg.
These great advances in the methods of |
fractures can not be at once accept
d by older surgeons who have opnosad DR.. |