, 1880-01-21
A SURGICAL FEAT,
Rebuilding n Patients Noae-Trans-
planting One or His Fingers.

Rebuilding Patients Noac-Trans-
planting Ono nr Ills Nlnxera.
Mn FORK 7Yn,ts inn. H.
A very extraordinary operation, and ono
that has only one precedent, ansl no complete
parallel In surgical hjstnry, Is now In progress
Mt Bellevue Hospital. Tho patient n young
inan q years IF ngc, Ind previously been
trenlea for degeneration Of the tissues Of
the nose, wltcl, IL described upon the l,aspltnl
regards under tho Bnmewhnt anomalous term
of n lupold Ulcer. lie wns also afflicted with
tho congonttnl malfortnatlon fnmliArly styled
the cleft palate, and Ind adcformity Of the lip
which caused considerable eycrstnn, nrd pre-
vented hin, from holding cigar or c!garet
between his lips. As llo was very fond Of
smoking, this state af facts WIS one that he
lalnentet exceedingly. To these troubles
which impaired the function of articulation
| aud materially intrrfcred with the probnbIl-
ity Of hlS obtaining rcmltl,oratiye employ
mcnt, ho added settled conjunctlsitis,
which Impaired his vision, prevented him from
reading more tllnn few minutes Mt q time, and
In consequence he wns obliged to sleep wilt,
lis eyes bantugcd in order to avoid the atl-
noyaucc given by flies to ,,lccrated or In
famed and semi purulent surfaces.
The iMlncdnte cn,lse Of the so-called
lnpold liberation Of the nose WIS blow
With club. received some years across tho
nose little below the bridge. Inflammation
and resolution we're followed by malignant
md progressive ulcer, which gradually
consumed Tie mucous, muscular, and
cartilaginous Tissues OF tho nose,
and finally attacked tho osscous
structures, Which, when lle was first admitted
to thu hospital, weru extensively nccroscd.
No history Of scrofa1a or other malignant
diseases cou1d be nttninetl and the ulccra-
tIon ultimately yielded to treatment, leaving
ar uns!ghtly opening which led directly to
lie postcrtnr cavities. The patients physical
constitution WINS mt only good, but rather
unusually strong, md, previous TO the nasal
note!! nlnnnE. his ncqunintallces for robust
lenItl. and extraordinary endurance.
m, Ss aicnT slX S d Gea 1c 6y te ftTeaes ~ Of
Illness of Ills physical appearance md suffs-
] clrntly restore his artcnfntton 10 enable hin,
70 get employment. distinguished surgeon
IL tls city whose name II sppressea by
unparalleled operation which llns been ut
tI1eting 80 many 9ieaicNl visitors to the hos
pilnl. within the Inst few days. This wAs
"sng ill., sf tin I'm nas the n a ds ." new
trNnsplantng tho second and third ptnlntigcs
of the middle finger, Of the left hand.
Their There exists IN surgical history, experts aay,
fl Birmingham. The patient was n young
wo!nan, WIG Ind lost tic tip Of the noso byi
malignant liberation, nnd the restoration corr
the left hand 10 supply tho place Of tho lost
SECTION Of the nasal Tissues, and a1nputat1ng
the finger IT the third ioint when union Ind
heen t,9 cstanlshe n this case tlle artery Of
the sevcnty-sGcofi day after the pri-
mary. operation, a,id the. ,nrnputatlon
s;nnn ;,i followed, while n tho Bellevue case
ligatl"'i was performed after about thirty
t!Mn n trn,'snlantatEon ot. the hmtl Of the
tinEer, n1itl was far less extensive ~ well as
for leSs complicated tlan tlie American
opssason y! every respect, the Engtisi cnse
certainly nat asa parallel Ta distinguished
I surgeon by whom the An1ericat operation
was inTfor'netl very frankly admits that 1t
while his surgical admirers aver ii.at tho lat:
ter, wns In no manner extraordinary, and
claim c,on,plota orIglna!Ity for American skill
AMI science In every essential detail.
proce.laffe w.s Very sl,aple: Tie Tic i mil wass M
! tlisscctGl from the tinErr to be trnnsplNntel
~ preliminary to tho work which was to fol.
lSSw; lsy mems OF two deep ircislons, one ut
siderable tlatss were brought down in such n
manner as to form 4 triangular mass over
ni!d nbo.ls t!le openInE left hy the destruction
sep Il S w sf 81 Dqss ss n of fffMTnKSs M sa M sSat sxs
70 forln a pocket ut the upper extren.
ity of the nos!, Into, whiei, tllo end
Of the tra1lsplnntcd finger WIS to, no
scqS scr x #%a S %efs It va 70 os scears ed IN
lew ntter preparatory movements, trIf!ing III
themselves, but essential to tile conception nf
the, operation, were completed. Tho next
md nlost lIup0rtMMt step was to lay open the
Inner aspert nf the llnger, from the second
| Joint u the tip with II single clean md per-
frct inciSlDl', whose WnflS, composed OF
minnie ysssGls. should suffer so little contu-
similarly frge s'irfacc would tako, place with
least pnssible inflammation AIld risk Ut slough
ing; ltWas isye weeks aEo Saturday that this
| mntnr lMlt nf the operation was performed,
by silver: s'it,lres alni Wooa 'sconpressor, Hle
henu nll!l trunk Of tue patient having been
previously cnyelnpcd ii, q plaster Of paris
e % tho sft aI " s ps"ner Po*
Is needieSs to sny that tie work WIS carried
OIL u M atmosphere permcatcd and per-
ns yns!esi VIII M anlsepie spray, n'nl TINT no
sure M :, psrttet I 1t: Union of Tic suTiases, VIZ
wns very carefully kept f.!r st,llle weeks, also
for hn!l tho opcTatlon failed, us there was q
scientific explanation could not .'iayo! sAvetl
tho operator frDm becoming Ms ridiculous In
tllo nlesilcat world Ms llo Is now likely to bo
Geebrlted. The venture WINS serious ono
solicitation of p patient who declared TINT
lio would rathcr lose NIL the fingers OF
his loft hand In repeated expert
ments than. to contemplate his flttura
] III tie condition III which lie then WIS.
IL the FIRST Instance, tho nature Of tho uccra-
t80n hy which the nasal tissues were destroyed
Was BY 20 means nscertatned, and its possl-
| hl% InlliFna1lcy,, when reaWakcned by THO
!nllamMntory action Of inclse'l surface placed
| the secand. some possible taint Of disease Ill
tho blood, dormant so long u.s. 1t was not pro-
llo aetisity T,'der lie strain Of tho operation. M
! The trlnl llns shown The futIlty of These
fcars, for thu npnosited surfaces hnye united
kindly, and there Inns been no failure any
whore, except III the loss, BY necrosis, Of tho
artificial pocket prepared to receive tlie tip Of
tho transferred ilnger. Il was scarcely OK
pecte!t thnt this would stand, rs It WINS !l,l-
practicable ta secure 1t by suturcs, mil tho
f9rco OF the compressor was insufficient for