Mountain Home bulletin. (Mountain Home, Idaho) 1888-1889, 1888-07-14
CUTTING OFF A LEG.

w LAW vi u ~ AANe |
REALLY AN EASY AND
eLoopLEss OPERATION.
Practical Surgery 10 . HospitAi-A Pa
tient ON the surgson's Tabss-How
Hsmorrhags ls l'revsntsd-Ths knife
at work-Ths Forceps.
An amputation, while . serious b really |
very simple operation. A Ayman who sees
m amputation Of q leg for the arst time Is
that there Ia about 1t 70 little that
Is startling or shocking to his nerves He
expects t. see serious hemorrhage
bleeding to death. He II surprised to 6nd
that, on the contrary, it Il one Of the most
bloodles operations performed on the sur
geona tabla The first leg amputation seen
by the writer was performed upon . man ot
middle age, who was suffering from advanced
necrusis. or death Of the bone Of the right leg.
Just below the knee The patient had been
brought into the amphitheatre Of tho city
hospital for treatment two weeks before the
time Of anlputation On the first occasion
he was not ready to submit to amputation,
although the doctor advised It. and the sur
geon 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 having been an In
Jury, and there was hardly chance Of saving
the kmb. The patient not having consented.
however, to lose the leg. the treatment at
that tine was limited to merely cleansing the
wound and closing 1t up. The doctor stated
then that even II the disease was checked and
cure was begun, it would require at least two
years for enough fresh bone to form to make
Q whole limb.
Mechanical appliances In the way Of arti
ticial limbs are now 20 skillfully made that
wooden leg, a. It Is ordinarily called, IL al
most a. good a. one Of Aesh and bone. II
certainly II not worth two years time to a
man in active life to spend In trying to save
q badly damaged leg. At all events. this pa.
tient seems to have come to that conclusion
and two weeks after his first appearance he
was again upon the surgeons table. and the
necessary Instruments for amputation were
by the side Of the operator. It was deemed
necessary to take of the leg just above the
knee joint The appliance which does away
with all hemorrhage ir amputation II called
the Esmarch bandageL This Is simply q long
belt of India rubber about two and q hall
inches wide. which is wound tightly abou,
limb. beginning at point below where the
amuputation is to be Made and extending
| spirally. like the stripes Of BARRIERS pole
but overlapping toward the body fol
| eighteen inches or more. and then at tht
point of the bandage nearest the body a stoul
rubber cord is tied very tightly The rubbe,
band Is then unwouni and the limb is lef
altogether blooiless and with the blood YES
sells tightly compressed at the point wher,
the rubber cord remains The effect Of wind
ing the .ubber about the lint in this way il
to drive the blood from all the veins and ar
teries back into the body. and to leave be
hind nothing but the bone anl tissues.
Then che surgeon begins his work. H,
need not hurry-he has plenty of time to d,
his work carefully and thoroughly. In th
case In ooint he propose> 20 cut the bon
about three inches above the knee Joint Th
desh was sound and healthy from the kne
Joint upward and it was necessary in this
IS in all cases ,f amputation. to 60 cut tn
tissues that there would remain flap. as |
ordinarily called. u flesh which should com
pletely cover the sud Of the bone where
was taken of. Taking rather narrow
bladed scalpel r surgeons knife, shar
pointed and with a blade about II inchs
long. he .apidly ,ut the flesh from the kne
pan iiagonally upward to the point where d
proposed 20 sevsr he bone and ,ikewlse !,
The opposite Iis of The limb making 4
shaped inclsi)n IN zach side II the L.
chiougb IL .ne assl-s % .ho bone Mt
ir,o II blood tOl,vsl "a, ourss II tn
knlfe n a.l - Srk. che uet,ng ,f .h
tiss'ies Acu oiAt carcely ;hree m4.,u.es. ~
then .hs ur yeo1 VS. resi1 q ise .hs "a :
Tbs ,ns;-,im ,nt. Urn ,ugh II ,ourse II Inc
max. vas % .c.callv he mme y that ,se
10 IN ,-diiary oa;ehrs moo and tn
surgeon 'tsej ; about shs .am, way An
aoous Is raoiuy - eu1chsr you'll c,l
through leg II eeef. This fnished the ,,
scutiv, oars It shs ,p.racion, ani il ha
occupi Vi scarcely I've minlsca
Tue more dslcaae AMI moro aedious .,ar
Of the operation followed Ttn somprlse
she taking up of the large and mail bloo
vessels and Tying up " ligaing :hsm- rh
important arteries and larger veins wer
easily discovered and the ends Of .hem .eize
with artery forcepa These sorceps were u
piled and lsft hanging to oerhaps = doze
blood vessels befors the ligating began. Thi
work was done by the surgeons asststan,
II consisted In tying the ends Of the vessel,
Just above the point where they were grippe
by the forceps. with strong catgut thread
Especially In .he case Of the arteries |, wa
necessary that this should be done with tn
greatest care, for II for any reason one G
these threads should give way there woul
be the greatest danger OF the patients bleed
ing to lsath before the hemorrhage could 3
checked After all .he blood vessels In sigh
had been .hus tied up, the rubber cord whic
bound the limb nsaI the body was looeenet