Savannah morning news. [volume] (Savannah) 1868-1887, 1884-06-01
A GREAT OPERATION.
How Professor Upset All Laws Laid
Down in Medical Books and Saved His
Patient.

Down in Medical Books and Saved Hi
Patient.
PhizadezpAia Chronicle Herald.
Prof. Fluhrer, of the visiting surgical
staff of the Bellevue Hospital, New York
recently presented to a large gathering Of
medical gentlemen in that city, among
whom were Profs. Lewes A. Savre
A. Post and Charles Mittendorf. Drs
Anderson, Putnam, jacob and others
the most remarkable case of successful
surgical operation of the brain
that ever came under the
observation of surgeon and
which still remains unexplained from the
fact that the patient recovered and is at
present enjoying the best of health. The
case has no parallel in the annals of
medical literature, and until it presented
itself the most eclectic surgeon would
have doubted the possibility of introduce
ing the knife into the brain without fatal
results. The patient, Bruno Knorr, who
sat in the amphitheatre of the
hospital, in the centre of a group of in
tensely interested physicians, who care
fully examined his head, which was a
mass of scars, showing where the bone
was cut out, has remarkable history.
He is a well-fOrmed young man, and We're
it not for his much-chOpped-up forehead,
would be quite good looking. He appears
to be of a very atfectiOnate disposition,
which is the cause of his strange wound.
On the evening of January 23d last he
visited his sweetheart and asked her to
marry him, but she declined. He pressed
his suit, but was fatty refused, upon
which he pulled out revolver and fired a
bullet into his brain. The ball entered
the forehead. about an inch and a half
above the eyes. directly in the centre. He
fell to the ground with blood gushing pro-
fusely from the wound. He was supposed
to be dead, but nevertheless he was re-
moved to Bellevue Hospital. Upon ar
irving at that place the junior surgeons
were surprised to find that he was still
alive. Through the night they sat by his
bedside. intent upon making observations
as to how long he could really live, APP
plying only such simple remedies as
would ease the last moments of dying
man. But they miscalculated, for in the
morning they found him still alive, al
though unconscious. Afraid to do any
thingApOn their own responsibility, they
telegraphed the visiting surgeon, Prof.
Fluhrer, at daybreak, and he came at
once in response to the summons, hardly
suppOsing that he could do anything for
the patient. From certain peculiar sur
rOundings, however, he was led to under
take a most hazardous operation, which
he described to his listeners While stand
ing at the side of the man whose life he
had saved.
Finding the pulsations of the patient
growing weaker and life slowly ebbing,
he took the most desperate chances, and
resolved to operate at once. Feeling as
sured the brain was wounded, from the
small particles of it's substance that OOZed
through the hole made by the bullet, he
boldly set to work, and, thinking that he
could no more than apply the last meas
ures he dissected off the flesh around
the wound clean to the bone, holding
back the flaps with pins, and then cut out
a disc of the skull about the size of a
dime with a trephine above the bullet
hole, joining the two by chiseling away
the bridge intervening. On attempting
to remove the particles of bone which had
been driven upon the brain matter by the
bullet in its passage and had set up
DANGEROUS condition by their pressure, he
met with prOfuse hemOrrhage from one
of the large arteries, which was cut
across it's gated edges scarcely to be
seen. Two attempts to catch it proved
futile, and realizing that death from loss
of blood under the circumstances was
matter of moments, he introduced his
finger into the wound and pressed the
artery against the bone, and for a time
became master of the situation. The eX-
ertiOn tired him soon, and he instructed
his assistant to relieve him while he
again attempted to catch the end. After
five trials he was successful and placed a
ligature of catgut around it. The little
vessel, however, was tricky, and the
ligature slipped off, leaving matters
worse than before. Again he tried it and
at last oyercame the obstacle by tying it
tightly. Next he introduced large bull
let-tipped probe, which descended by it's
Ovrr, xxroiCrbf oil fiU0 into tbo
brain, when he stopped short and held it
in plaza, Carefully studying the angle in
Whic2.lt entered he marked a point at
the back of the head where it would if
further pushed come out, and there cut
off three flaps around it and sawed
through the bone, exposing. the brain
coverings in the rear. There he cut
through and met with a mass of dark,
half-clOtted blood mixed with particles of
brain, which floated about. This was
carefully washed out He passed in a
probe smaller than the first and felt the
bullet lodged as it was in the brain.
With delicate forceps it was pulled out
through the opening behind. The opera
tiOn occupied four hours. A rubber tube
was drawn into the wound through the
channel cut by the bullet by means of
which the septic matter was allowed to
flow. 1t remained there for over a month
until recovery naQ so lar advanced JnaC
the patient was declared out of danger, to
the surprise of all and in conflict with
the established rules in surgery. Prof.
Fluhrer enlightened his hearers with the
treatment after the operation and pre-
scented a chart showing the variations of
the pulse, temperature and respirations
which he observed during the progress of
the case. He LAID great stress upon the
difficulty he had in drawing out several
horse hairs, which he introduced around
the drainage tube to prevent its adhering
to the walls of the wound. After the
most critical stages had passed it was
found that KnOrr had lost his memory,
powers of speech and was partially
paralyZed, but he has recovered all his
faculties and pronounced himself as safe
and sound as a dollar when questioned by
the doctors. The nearest approach to
Knorr's case is one reported by Prof. bet
mold, who about fifty years ago trephined
the skull of a patient suffering from an
abscess of the brain, which he located,
and, by trephining the skull, exposed the
brain and opened the abscess by cutting
into it, but the patient only survived a
few months, when he died from a recur-
renee of the disease.