The farmer and mechanic. [volume] (Raleigh, N.C.) 1877-1885, 1884-07-16
Extraordinary Case Of Conserva-
tive Surgery at St. Vincenrs
Hospital.

"Such extraordinary progress Is now
being made In the science OF surgery
said DR.. Keene, The house surgeon OF St
Viucent's Hospital, 10 a Herald reporter
on Monday, that, although, Ui course,
sc shall never be able 10 create a human
being out of InanImate matter-a second
Franken>tein. a. II werc-yet we can
patch up an injured or incomplete human
organism in a manner which would have
been considered utterly impossible a quar-
ter of a century ago. There i a case
here 10 the hospital now which. in its
way, Is even more remarkable than that
of Charles Hoffman. the operation upon
whose brain was detailed IN the HeTdtd
a few days ago.
BERNARD Nierney is the name OF the
patient of whom | speak. He was en-
ploycd two weeks ago in laying the blue
, stone tagging on the sidewalk IN front OF
the newly enlarged dwelling house at the
northwest corner of Clinton place and
Fifth avenue when the corner stone, q
block weighing four tons, rolled from the
hand trucks, on which 1T was being prled
along 10 It's place, and, knocking Nierney
down, pinned his legs to the ground. 1t
was ten minutes before the ponderous
stone could be lifted, and hen both legs
were found to be crushed TO a Jelly. He
was at once brought here 10 one of our
ambulances.
1T seemed at first that amputation of
both legs would be absolutely necessary
in order to save his lite; but at length we
determined to try an experiment never
before attempted in surgery. La both
legs the tibia and hbula, that is. the shine
bone and the smaller one behind IT, were
crushed into a dozen pieces Tor a length
OF about SIX inches, extending from just
above the ankles nearly TO the knees.
We first removed all the pieces and
splinters OF bone, taking great care, how
ever, to leave the perIOsteum, or mem
brahe surrounding the homes, a. tar
intact as possible. This membrane is
like the bark ola tree. Il ii be removed
the tree dies.
After a long and very delicate opera
ton we extracted all the bone, but left
the hollow sheath of the periosteum COM
paratlvely intact. Now came the most
remarkable part Of the case. The main
arteries 10 both legs had been crushed
and torn SO badly that there was no pos
sibility of sewing together the pieces,
which were literally in tatterS for half the
distance from his ankles to his knees.
But unless these arteries could be Joined
together the feet and ankles would wither
away from lack of the necessary supply
of blood. We therefore entirely removed
the injured portions of these arteries and
inserted very slender tubes OF decalcifed
bone, about as large as a pipe stem, into
the severed ends, and then bound them
fast with catgut thread, thus affordipg
an uninterrupted flow OF blood through
the mutilated portions of the legs down
into the feet. We next drew together
the nerves and muscles, all of which had
been crushed and severed, and united
them with catgut thread and then put up
both legs in plaster. That was two
weeks more he will be able to walk on
crutches, and in two months from now
this man, whose legs for a distance of
six inches were crushed as fiat as my
hand, the bones In them shivered to
spllntcrs and the arteries, muscles and
nerves either severed or totally destroyed
this man will walk out of the hospital
with almost as sound a pair Of legs and
feet as yours or mine
But will those tubes always remain
In his legs in place of the arteries? z"
Not longer bar two months or so.
The ends of the arteries will gradually
grow over the tubes toward each other
until they meet, and by that time the
tubes, being of decalcified bone, aud the
catgut threads will have been completely
absorbed"