The Indianapolis journal. [volume] (Indianapolis [Ind.]) 1867-1904, 1883-08-06
RARE SURGERY.
A Critical Operation Performed in the Pres
ence of One Hundred Physicians.
Now York Times.

NoW YORK Times.
On Thursday afternoon of last week DR.. f.
LANCE, one of the visitingsurgeons at Belle
vue Hospital performed a rare operation
upon an aneurism of the external lilac artery
in the presence of nearly 100 physicians.
Among them were Dr. A. Fluhrer, DR.. Lit
tie, DIR. Henry B. Sands, DR.. Charles Phelps,
DR.. Whittemore, of New Haven, and DR..
Smith of the United States army. Invita-
tations were sent to all the prominent sur
geons of the city, but few could be present,
and the attendance was comprised prin-
cipally of the house stats of the various city
hospitals. The patient is a flute player,
thirty-six years of age, and was formerly
employed in one of the theater orchestras of
this city. He had been troubled with the
aneursm for nearly year. 1t showed it
self in his left groin, where it caused pro-
tuberance the size of a hens egg
of his left leg was so great as
to cause numbness of that limb which, in
time, became nsarly paralyzed. Three weeks
ago he consulted Dr. LANCE who advised an
operation, and he was accordingly admitted
to the hospital. On Thursday afternoon he
was taken into the hospital amphitheater
DIR. LANCE, assisted by DIR. Charles McBurney,
DIR. Samuel Lewengood, DR.. Robert T. Nor
ris, and DIR. w. T. Wardwell, cut through
the patients abdominal wall, into his abdo-
men. The intestines were turned to one
side, while DR.. Lange reached into the
orif1ce and tied the common lilac below the
point where it branches off from the aorta
and just above the aneurism. The intestines
were then replaced, the cut sewed up. and
the patient restored to consciousness. More
than week has elapsed since the operation,
and the patient is considered likely to re-
cover If the aneurism had been allowed to
remain the continued flowing of the blood
through it would have enlarged it and
weakened its walls, and it would have been
likely to burst with the slightest strain. 1t
would have increased III size with time and
the abnormal pressure upon the surround
ing organs and nerves would have led to
various disorders.
The operation stops the flowing of blood
through the aneurism, which becomes hard
and smaller. 1t also stops the circulation
through the lilac arteries which supply the
left leg with its sustenance, causing the blood
to course from an overflow, as it were from
the upper part of the body through the small
blood vessels which form chain of conduts
all over the system. If this collateral circu-
lation is not sufficient to give the member its
life, it will probably have to be amputated.
This is one of the dangers to be feared.
Among the other effects which may follow
such an operation are pyRmia, or blood
poisoning, from the sloughing of the sac of
the aneurism peritonitis or inflammation
of the lining mem brane of the abdominal
cavity, the loosening of the ligature which
binds the lilac, and secondary hemorrhage.
The patient sometimes never RECEIVERS from
the shock of the operation. The operation is
one of the rarest known in surgery. and has
been seldom performed. DIR. Erichsen, in
his standard work on surgery, in 1879 said
that it had been performed forty times with
only ten recoveries. 1t has been performed
a number OF times since then with the same
proportionate results. DIR. Sands once per-
formed it in this city. The patient recovered,
but his leg had to be amputated afterward,
gangrene resulting from imperfect crcu-
lation.