The Democratic advocate. [volume] (Westminster, Md.) 1865-1972, 1884-09-27
demonstrating a Face.

Bertha Kistler, who for eighteen months
has been under treatment by DIR. George
f. Shrady, visiting surgeon of the Presby-
terian Hospital, New York, has left the
institute living, grateful monument Of
surgical ingenuity and skill. Bertha Kist-
Ter is now about twenty years old, and fif-
teen years ago she was treated by an un-
skilful surgeon in Germany for supposed
cancerous growth in the left cheek. The
ailment proved to be of another character,
but the operation destroyed all symmetry
of the child's face; leaving a large hole in
the cheek, and the mouth and nose fright
fully distorted. Eighteen months ago the
girl called on DIR. Shrady to discover if
anything could be done to remedy her de-
formity.
She was only poor working girl, but
begged to go to the hospital and pay for
treatment by work DIR. Shrady held out
little encouragement to her, but at last con-
sented to undertake the task of building
up virtually new countenance. Soon
after the first operation was performed, and
in the course of year it was followed by
sixteen others. Most of the face was made
over by transportation of flesh from ada
cent parts.
The most important step in the treat
ment of the case was the filling up of the
hole in the face. For this purpose large
skin flap was wanted. 1t was obtained by
DIR. Shrady in the following manner: A
rectangular section of skin was partially
separated from the girls left arm above the
elbow. An incision was made in the side
of the forefnger of the right hand, extend
ing from the first joint around to the thumb.
The hand was then brought over to the left
arm, and the detached edge of the skin flap
was sewed into the incision in the finger
with fine silver wire. The hand and arm
were kept immovable by plastic bandages.
In about week the skin flap became unit
ed to the hand, but the flap was principal
ly nourished from the arm. To change the
current of nutrition the flap was gradually
cut from the arm, and when it had been
nearly severed the finger, and not the arm,
kept the skin flap alive. When this be
came apparent the entire skin flap was am
putated from the arm. The hand, with
the ingrown flap, was then brought up to
the face, the SCARED skin on the left cheek
was raised and the flap was inserted under
meath. The hand was kept in position by
plastic bandages and plastic cap. In
three weeks the flap became attached TO the
face; the current of nourishment was
changed by gradual amputation from the
finger, and finally, when entirely separated
from the hand the skin flap taken from
the arm became the foundation of new
check
With natural anxiety Dr. Shrady
watched the growth of the flesh, and at
last had the satisfaction of demonstrating
indubitably the feasibility of transplanta
tion of flesh from one part of the body to
another by using the hand as a medium.
New difficulties then arose. The surface
of the face was rehabilitated, but the girls
mouth was drawn out of shape to such an
extent that the corner was almost directly
under the nose.
To restore the mouth DR., Shrady decided
to enlarge it on one side and sew it up on
the other, and after this was done the lips
were cut into the true and proper shape
and all traces of distortion had disappeared.
With the success of this last operation,
which made twenty in all, the labor was
ended, and nothing was left but to await
the healing of the incisions, These have
at last become satisfactory and the girls
face is shapely once more, but, of course,
slightly disfgured by scars. Most of these,
however, are from straight, clean cuts, and
it is expected that even they will eventual
ly become imperceptible
From the first moment of her long mar
tyrdom the girl has not faltered for an in
slant, but has even been impatient for the
next step. Sometimes the doctor would
try to persuade her to forego for time the
operation, but she persisted in her desire.
The gratitude she evinces toward DIR,
Shrady is immeasurahe. A singular feat
ure of the case is, that Notwithstanding the
suffering she must have experienced, she
has grown very fat,