The morning news. [volume] (Savannah, Ga.) 1887-1900, 1888-05-16
nd THEY CUT OFF A LEG.
AnonAtion is Really an Easy and
RloOdlesS Operation.


thcsholumns week ago, becomes familiar
verearly in his hospital observations with
thareat variety of operations coming I'M
,sI the head of amputations, either of
fIers toes, hands, feet or whole limbs,
CIV operating day az the City and Massa-
ctetts General Hospitals. The class
of amputations performed in the
plic amphitheater is confined
ublly to cases in which the
oIntion has been made necessary by
Nbes more or less remote. All cases of
sIhen injury which makes amputation
blessary are treated promptly in the ACCT
At room, for it would, of course, be impoS-
sic to postpone such an operation until
Il assembling of class of students on a
fld day in the week. The cases which
Che before the students are, therefore,
tbse in which efforts to save an injured
lib have proved futile, or those in which
she local malady, such as incurable dis
ekes of the bone or cancerouS affection,
nike amputation advisable.
An amputation, while a serious, is really
aerv simple operation. A layman who
SIS an amputation of a leg for the first
fine is surprised that there is about it so
ltle that is startling or shocking to his
rh,ves. He naturally expects to see serious
bnorrhage and rapid work to prevent the
rltient's bleeding to death. He is surprised
tfind that, on the contrary, it is one of
he most bio dess operations performed on
tie surgeons table. The first leg amputa-
tn seen by the Sun correspondent was
Uniformed upon a man of middle age, who
WIS suffering with advanced necrosis, or
dath of the bone of the right leg, Just be-
Low the knee The patient had been brought
inb the amphitheater of the City
Hopital for treatment two weeks before
thetime of amputation. On the first oc-
casbn he was not ready to submit to ampu-
tati,n, although the doctor advised it, and
the surgeon then operated upon the bare
chance of saving the limb. He found on
examination, however, that great cavity
had formed in the bone, the first cause hav-
ing been an injury, and there was hardly a
cbanc9 of saving the limb. The patient not
having consented, however, to losing the
leg the treatment at that time was limited
10 merely cleansing the wound and closing
t up The doctor stated then that even if
the disease was checked and cure was be-
gun it would require at least two years for
enough fresh bone to form to make whole
limb.
Mechanical appliances in the way Of arti-
fetal limbs are now so skillfully made that
& wooden leg, as it is ordinarily called, is
almost as good as one of flesh and bone 1t
certainly is not worth two years time to a
man in active life to spend in trying to save
a badly damaged leg. At all events, this
patient seems to have come to that conclu-
sion, and two weeks after his first appear
ance he was again upon the surgeons table
and the necessary instruments for amputa-
ton were by the side of the operator. 1t was
deemed necessary to take off the leg Just
above the knee joint. The appliance which
does away with all hemorrhage in amputa-
ic na1laI ba hon
Is simply a long belt of India rubber about
o. inches wide, which is wound tightly
about the limb, beginning at point below
where the amputation is to be made, and
extending spirally, like the stripes on a
BARRIERS pole, but overlapping toward the
body for Is inches or more, and then at
point of the bandage nearest the body a
stout rubber cord is tied very tightly. The
rubber band is then unwound and the limb
is left altogether bloodless, and
with the blood vessels tightly
the rubber cord remains. The effect of
winding the rubber about the limb in this
way is to drive the blood from all the veins
and arteries back into the body, and to
leave behind nothing but the bones and It's
sues. Then the surgeon begins his work.
He need not hurry-he has plenty of time
to do his work carefully and thoroughly.
In the case in point he proposed to cut the
bone about three inches above the knee
joint. The flesh was sound and healthy
from the knee-joint upward, and it was
necessary in this, as in all cases of amputa-
ton, to so cut the tissues that there
would remain a flap, as it Is ordi-
narily called, of flesh which should
completely cover the end of the bone where
it was taken off. Taking rather narrow
bladed scalpel or surgeons knife sharp
pointed, and with blade about 10 inches
long, he rapidly cut the flesh from the knee
pan diagonally upward to the point where
he proposed to sever the bone, and likewise
on the opposite side of the limb, making a
N-shaped incision on each side of the leg,
through all the tissues to the bone. Not a
drop of blood followed the course of the
knife in all it's work. The cutting of the
tissues occupied scarcely three minutes, and
then the surgeon was ready to use the saw.
This instrument, although, of course, of finer
make was practically the same as that
used in an ordinary butchers shop, and
the surpeon used it in about the same way
and about as rapidly as a butcher would
cut through leg of beef. This finished
the executive part of the operation, and it
occupied scarcely five minutes. The more
delicate and more tedious part of the opera
ton followed. This comprises the taking
up of the large and small blood vessels, and
tying up or ligating them. The impor-
tant arteries and larger veins were easily
discovered, and the ends of them seized
with artery forceps These forceps
We're applied and left hanging to per-
haps dozen blood-vesSelS before the
ligating began This work was done by
the surgeons assistant. 1t consisted in
tying the ends of the vessels just above the
point where they were gripped by the
Iorceps with strong catgut thread. Es-
peclally in the case of the arteries 1t was
necessary that this should be done with the
greatest care, for if. for any reason, one of
these threads should give way, there would
he the greatest danger of the patient
bleeding to death before the hemorrhuge
could be checked. After all the blood
vessels in sight had been thus tied up, the
rubber cord which bound the limb near the
body was loosened, and then occurred the
only hemorrhage of the entire operation.
There remained in the exposed stump of
the limb fifteen or twenty small blood
vessels which could not be detected by the
eye while the limb was bloodless and the
location of which was shown by the flow of
me blood itself. When the banda9e had been
iioosened, the surgeon, standing ready with
handful of artery forceps, rapidly seized the
ENDS OF the exposed blood-vessels as fast as
the location of them was indicated, and jn
Two or three minutes the hemorrhage was
checked, and the end of the limb was hung
with great bunch of curious little steel
implements. These smaller vessels were
taken up one at a time by hgatures, in the
same manner that the Others had been, and
fhs. l..sN H.. a 4 L. Let