The morning call., 1890-11-28
FOURTH OF THE KIND.
The Peculiar Surgical Operation
Performed in New York.

A remarkable surgical operation was per-
formed in the Mount Sinai Hospital in Lex
ington avenue, New York, recently. 1t is
thought 1t is the first of its kind ever per-
formed in this country. The operation was
the removal of the entire left arm, shoulder
blade and cOllar-bone, and the muscles at
tached thereto, OF man "a years old. Ac-
cording to the records such an operation has
been performed only thrice before. once in
France and twice in England. The patient
is Judah Halprin. native of Russia and
tailor by trade His malady was a maljg-
nant tumor, which affected the shoulder.
1t was necessary to prevent the possibility
of a cancerous growth to remove the shOul-
der blade and collar-bone The operating
room OF the hospital was crowded with mem
bers of the medical profession. The tables
were covered with bottles and basins filled
with weak and strong solutions of bichloride
of mercury, the antiseptic used. The surgi-
cal instruments were soaking in china basins
filed with 3 per cent carbolic solution.
The patient was borne into the room under
tie influence of ether. When placed OH the
operating table he was unconscious. but was
not fully under the influence of anesthesia,
for he feebly moved his hands toward his
head as if trying to remove the cone from
his face. Soon. however, the mechanical
movements ceased, and his heavy breathing
became easier. After the parts to be am
putated had been thoroughly cleansed by
soap and water and one-thOusandth BIZ
chloride solution a March bandage "a fiat
rubber band about three inches wide) was
wound around the left arm from the hand
to above the elbow. This was to drive the
blood from the veins and capillaries back
into the general circulation, and so reduce
the loss of blood in the anputation to mill
imum. A round rubber ligature was then
tied above the bandage to prevent the re-
turn of the blood, and the bandage was re-
moved. An assistant raised the arm and
held it in position. The surgeon took the
knife and with one long sweep made an in-
cision the entire length of the colar-bone
and down back over the shoulder-blade.
There was slight rush of blood, which was
quickly sponged away by the nurse. The
hone lay bare. A few small severed ar
teries were caught with forceps and tied
with ca gut lgalures. The cartilage joining
the collar bone to the breast-bone was next
cut and the clavicle was raised and re-
moved. The sub-clayian artery. the large
vessel which supplies the arm and shoulder
with blood, was then exposed. An aneur-
ism nerdle threaded with catgut was passed
beneath the artery. This needle was then
withdrawn. leaving the double catgut be-
hind. The artery was then tied. The skin
was dissected back over the shoulder, the
remaining small arteries which run to the
back of The shoulder-blade secured, and the
Shoulder-blade exposed. The muscles which
hold 1t to the back were severed. A circu-
lar incision wa, then made beneath the arm
and through the muscles of the breast. This
left the arm, to which the shoulder blade
was still attached, joined to the body by only
little tissue, the sub-clavan vein and ar
terry and the brachial nerves. This vein
was also tied, and the parts were then sew
cred, and then the arm and shoulder-blade
we're lifted from the body and laid on the
table. The entire left side was gone, and
yet The blood lost did not amount TO table
spoonful The ribs lay exposed.
At this stage the patient breathed easy
and seemed but little exhausted. Dozens of
bright artery fofceps still hung to the body
but they were removed after the small blood
vessels which they had held had been tied
with catgut ligature. Hot bichloride sponges
were stuffed into the opening, and the sides
of the wounded parts were pressed together.
After an instant the spoDges were removed
and all bleedibg had ceased. The inside
was thoroughly washed out with one-thou-
sandth solution of bichlorde of mercury.
The loose flaps of skin were brought to-
gelher and sewed with silk, anu several
small drainage tubes inserted to keep the
inside of the wound Clean. Iodoform dust
was sprinkled over all the seams, and thin
strips of rubber protection were laid above.
Next came iodoform gauZe. followed by car
boiZed gauze, and then the body was
swathed in cotton and bound by roll after
roll OF cheese-clOth bandages, the ends be-
ing fastened with safety-pns. The opera
tiOn occupied one hour and forty minutes.
The patient will be at home next week,
minus his left arm, shoulder-blade and
colar-bone.-St. Louis Post Dispatch.