New-York tribune. [volume] (New York [N.Y.]) 1866-1924, 1881-05-31
SURGICAL SKILL.
,,S,,opv Of A REMARKABLE CASE.

~ -.r,orkable surgical operation was per
.,~.er,Iv iu Vienna, by Professor Theodore BILL
80 ~h,.b marks step IN the art OF meaning W
49, =, "a the first record where inc re"o' :"
a.. r.rt of the human stomach Win tunioi s"1
-. attached has been successful John a. hsrs 49,.
y,n,tsA states Minister TO Austria, mas sent " tha
uxx the report wheh fi0i'''''
go In II be says: ..,.o,,. y,
esee ova, az the frequently occurring carchona VI
lug s .caust which all internal remedles nave
~ ,,aa in vain, by the aid OF surgery mas o"e 80
p -. ~ debate. Seventy years ago youns p"'
'e y,i theodore Merrem pubhshed Painpnie' ="
c'an, - Accommodated by experiments mace upon lneo
when nc noh surviyed the operation, that IT was
oos .. ont out the pylorus and to join the duoueu
~ ~,ouach He went 30 far as 70 propose
va. De-ation in cases Of human beings sunoiie
.-ahIe carcinoma OF the pyorus. In tnose u"'' W
rot,on that the processes OF hfe their n''oii
- ,,.,r soualizatiOn, we're essentially the Same -.
su,ar hody and that Of animals, had not oo'aneo o.
..,, nor had the operative technique advanced iai
eoh'v' .a the significance OF these experiments 10
-, a,nrecated and to render the appncation Vi tlo
s.,oiogical result upon the human body posspie nv
n.st mrgeons Of France England ana 1erHiS"S -, :,
shs course of this century discussed Tue oeS' -
,o,ning wounds Of the stomach and the intes'ie'
the discovery by Lembert Of the only true prin0'p'
'no 80 49,. oa,a,ion cap be carried out success
su .stts,sc.orv results became OF more irequc" w
srca Rut the excison Of diseased parts OF INC III
,estsncs WA not attempted until soou' "n 'o
Tn 1871 demonstrated the possDiity vi ou'u"e ~
actions of the esophagus In large dogs, anu 'n"' %
und healed leaving the esophsgus slightly contractor
49,, eas,,v IN he dilated Czerny the first 10 carly
out this operation successfully upon human oehs ne
nsrments 70 extirpate the larynx led to my sucoeS
t,,v removing human larynx Obstructed py cancer
nus growth In 1877, succeeded In performing 'no
operation Of gasterorsphy which proved that no
need be entertained TO the gastric juices OF tne s
ach interfering with the scar tissue so a 10 pre a0ou
Its solution. ,.o,
,ns orn,on that nv operation is reckless experiment
ON human life. Such opinion cannot be entertainer
for one moment The operation OF cutting out parts o
the human stomach has like any other new operauoh
been prepared anatomic-physoloHcauy ana tecninoay
nv myself and my assistants. Every surgeon having
.nv exnerence In experiments animals. and similar
nera,ions upon the human body arrives at the conc1u
MON that this operation must and VIII succeed feSn
the Paris surgeon WAS OF the same opinion lie at
TAINTED the removal of cancerous pylorus about ak
centimeters In diameter In the case OF patient very
much reduced by suffering and who died four days after
,hs onerston His method Of operating. and especially
nj, choice of cstgut sewing material did not seem TO
me rood one He has not attempted TO repeat the ope
ration 40 far as know and ether surgeon has ven
turcd TO undertake this by no means easy task
CUTTING CANCER FROM THE STOMACH.
"Tbe few cases which came under my notice in the
OF the past year ulu not seem W
oues for first operation OF this kind II was only re
,en.,v that the case of O woman presented 10 me
where the diagnosis OF pylorus was certain
After few days Of observation the patient asserting,
made up my mind TO undertake the operation. The
woman about forty three years of age and mother OF
eight children taken sick-very suddenly 1t would
seeu-in October, 1880. with vomiting The symptoms
Of cancer OF the stomach with stenocis Of the pylos
scop showed themselves The only thing she able 70
retain for any length Of time was milk The prep
aratons for the operation consisted tn accustomnG the
patient peptoniEed Injections and the cleansing Of the
stomach by the wellmown method Of injection and
pumping The room, specially prepared for the OCCASION
was heated 24o r. and the narcotic administered by
Of my assistants, everyone of whom seemed TO be
conscious of the importance of the undertaking No in
terruptiOn and not minute OF unnecessary delay
CURED The movable tumor, lying little TO the right
seemed to be Of the size OF ordinary apple diagonal
lncsion eight centimeters long made the
tumor, which proved TO be notty and infltrated
the pyiorus, occupying than third OF the
lower portion OF the stomach Separation Of the adhe
sion the omentum and the transverse colon followed
then the division Of the large and small omentum Every
tied before being cut the loss OF blood being
very small. The tumor turned out over the abdOm
nal walls and cut then made through the stomach
one centimeter beyond the infrated part at first only
backw ard then in the through the duode
num- The attempt put together the edges Of the
parts showed the possibility OF joining them Six stitches
taken through the edges bat the threads not
yet tied and only used to retain the edges in position
further cutting through the stomach was then made
disgonay from the upper and inner TO the lower and
outer SIDE but always at distance OF centimeter
om the ntrsted portion Of the coating of the stom
ach The next thing done to Join the diagonal cut
upward until the opening WAS small enough TO 6 the
duodepum TO IT. complete separation OF the tuInor
from the duodenum effected next by ncision
centimeter the other side OF the innltrated portion
and parallel 10 the cut through the stomach Then the
duodenum introduced into the opening left in the
stomach About fifty stitches taken with Czcnys
carbozed silk The whole ceansed with per
carbolized solution. The stitches then examined
and few more added where there seemed TO be weak
spots. The whole replaced In the abdominal cavity
the outer wound closed and the bsndages applied
The operation lasted about hour and half No |
weakness vomiting and pain seemed be appar-
ens after the operation. The patient given ice only
In the nst twentyfour hours then pcptonsed infections
With wine. On the following day at first every hour
ony, then every half hour, Tablespoonful OF milk
The woman slept the greater part OF the night with the
Tor days ar ths ine on ood taken
-one litfe day "a an attempt " DOurish the patient
bed Injections dispensed WITH AZ they produced
nnatnlence and collie Injections Of wine three times
own request few days later the general
ward and she ban since been discharged from the hos
curvature lhorrble dictu fourteen centmetcrs and IL
u With difficulty only that enabled pass a goose.
gull through the pyorns The shape ~ the stomach s
changed little by the operation. Is only little smaller
chan formerly"
WORK OF AMERICAN SURGEONS.
swell, this IL very remarkable operation indeed"
sad DR.. Lewis A sayre, when reporter OF THE TBUsH
had finished reading DR. Bllroths OF the case
b II marks step in the science OF surgery. Tho
operation has been believe. attempted but few times
Europe, but has always proved fatal In this country
4 has never been attempted. far know Professor
n ~ moaf amin tfa 20 |
sno was also the first TO successfully cxtirpoc dscascd
larynx There are few surgeons In this country who
would have yentured 70 undertake this extremely diff
cnlt operation"