The new North-west. [volume] (Deer Lodge, Mont.) 1869-1897, 1888-07-06
CUTTING OFF A LEG.

CUTTING OFF A LEG.
AMPu1ATION REALLY AN EASY AND
GLOODLGs3 OPERATION.
Practical Surgery In q Hospitai-A Pa
tient an tho Surgeons Table-How
I!emorrhage I. rreventcd-The Knife
1T Vork-The Eorcep..
An amputation, while a serious is really a
very simple operation A layman who sees
an amputation Of a leg for the first time is
surprised that there is about it so little that
is startling or shocking to his nerves. He
naturally expects to see serious hemorrhage
and rapid work to prevent the patients
bleeding to death. He is surprised to find
that, on the contrary, it is one Of the most
bloodless operations performed on the sur
geon's table The first leg %amputation seer
by the writer was performed upon a man Of
middle age, who was suffering from advanced
necrosis, or death Of the bone Of the right leg,
just below the knee. The patient had been
brought into the a~mphitheatre Of the city
hospital for treatment two weeks before the
time of amputation. 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 a great cavity had formed in
the bone, the first cause having been IN in
jury, and there was hardly a chance Of saving
the limb. The patient not having consented,
however, to lose the leg, the treatment at
that time was limited to merely cleansing the
wound and closing it up. The doctor stated
then that even If the disease was checked and
azure was begun, it would require at least two
years for enough fresh boae to form to make
a whole limb.
Mechanical appliances In the way of arti-
fetal limbs are now 30 skillfully made that q
wooden leg, as it is ordinarily called, is al
most as good as one Of flesh and bone. It
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 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 amoutation were
by the side of the operator. It was deemed
y W. WAA VI Su0 u IOSO dOOt0 Wig
knee joint. The appliance which does away
with all hemorrhage in amputation is called
tho Esmarch bandaga This is simply a long
belt Of India rubber about two and a half
inches wide, which is wound tightly about
limb, beginning at a point below where the
a~muputation IS to be made, and extending
spirally, like the stripes Of a BARRIERS pole,
but overlapping toward the body fc
nS~hkoaN S,,ohoO ~ rnrro and klo> "a 4.
point Of the bandage nearest the body a stout
rubber cord IS tied very tightly: The rubbe,
band Is then unwound and the limb is left
altogether bloodless, and with the blood YES.
sells tightly compressed at the point where
the rubber cord remainA The efectof wind.
ing the rubber about the limb In this way Is
to drive the blood from all the veins and ar.
teries back into the body, and to leave be-
hind nothing but the bone and tissues,
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 proposes to cut the bone
about three inches above the knee joint The
.fesh was sound and healthy from the knee
Joint upward, and It was necessary in this.
rs in all cases of amputation, to so cut the
tissues that there would remain a flap, as it
ordinarily called. Of flesh which:should COM
;pletely cover the snd Of the bone where it
was taken of. Taking a rather narrow
,bladed scalpel or surgeons knife, sharp
pointed. and with a 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 IN
the opposite side Of The limb. making a Y
shaped lncision IN zach side # the leg
through al she dss1es to The bone. Not a
drop IT blood tolowal 5he course 81 the
knife In al is work. The cutting ST the
tissues occu3ial scarcely shree minutes, and
then ths surgeon vas ready % use Tho saw
This instrument although. IF course, ST finer
maka. vas practically The sams as that used
in an ordinary butchers shou. and the
sur.eon used i IL about che sarns wag and
aoou. IS raqiu ~ IS \ butcher would cut
through ; leg Of heel. This finished the AZ
scuti7, part IT the operation, and It had
occupis I'd scarcely five minutes
The more delicate and moro tedious part
Of the operation followed. This comprises
the taking up Of the large and small blood
vessels and tying up or ligating them. The
important arteries and larger veins were
easily discovered and the ends Of. them seized
with artery forcepa. These forceps were M
piled and left hanging to perhaps = dozen
blood vessels before the ligating began. This
work was done by tho surgeons assistant.
1t consisted in tying the ends Of the vessels.
just above the point where they were gripped
by tho forceps. with strong catgut thread.
Especially in the case Of the arteries it was
necessary that this should be done with the
greatest care, for II for any reason one Of
these threads should give way, there would
be the greatest danger Of the patients bleed
ing to Heath before the hemorrhage could be
checked After all the blood vessels in sight
bad been thus tied up, the rubber cord which
bound the limb near tho 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 de-
tected by the eye while the limb was blood
less, and the location Of which was shown by
the flow Of the blood itself. When
the bandage had been loosened, the
surgeon, standing ready with q hand
full Of artery forceps, rapidly seized the ends
OF the exposed bloodvessels as fast as the
location of them was indicated, and In two
or three minutes the hemorrhage was checked,
and the end Of the limb was hung with q
great bunch of curious little steel implements
These smaller vessels were taken up one at a
SA"~ ~ A6NSOASS IA WIG otkA40 uXk4u0I GQ1O
the others had been, and when the last had
been tied, and the last pair Of artery forceps
had been removed, the wound was ready to
he closed up.
4 It was:1arst treated with antiseptic solution
and powder in order to reduce to q minimum
the danger Of Inflammation and to increase
the chance of the wounds healing by first in
tention. Then the two flaps above and below
the bone were brought together over it, and
the edges Of the skin were carefully sewed
opposite to each other, and the operation was
over: 1t had occupied altogether about forty
five minutes The patient during this time
remained apparently asleep. The operation
had been entirely painless, and when the
bandages had been applied and the ether como
removed from the patients face, he was
carried from the amphitheatre Just as he
began to show signs OF consciousness.-Bos-
Cor. New York Sun.
Why Girls Eat Candy.
american girls eat more candy than the
girls Of any other nation" said an observing
recently to o reporter. "They COM
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until New Years eve. Always candy; some
because it is a birthday, sometimes be-
cause they meet q friend, sometimes because /
It was sent to them. They have as many ex-
cuses for eating candy as a man has for