St. Paul daily globe. [volume] (Saint Paul, Minn.) 1884-1896, 1890-05-11
OUR MODERN SURGERY
What Medical Science and
Nerve Can Accom-
plish.
A Life Saved by the Trans
fer Of Human
Blood.
An Irisbman's Noble Saeri-
flee to Save a Dying
Woman.
He Is Bled That His Warm
Blood Might Instill Life
Into Another.

lUGO AlOCuGHs.
New York Letter.
Nature gets tired once in while Of
the regular and monotonouS fulfillment
of law, both in the creation and deStruc-
ton of things material and immaterial,
and then goes Off on a tangent and does
something phenomenal and out of the
usual run that sets the sword talking.
MOnstrosities can be accounted for in
no other way. One of the most original
and best known productions of nature
in the monster line were the SiamtSe
twins. who were joined together by a
ligament of flesh attached to the side Of
the abdomen. They were healthy, en-
joyed life, and were the wonder of the
aye in which they lived. This physical
union was truly remarkable, but it has
been surpassed by joining of two per-
sons together artficially, as will appear
in the following narrative:
The patient is Alice Muslin, who
comes from from the old Quaker fam
lily Of this name in Philadelphia, and is
fifteen years old. She is boarding at the
Lexington avenue private hospital,
where she was taken over a year ago
for surgical treatment. The first eXhl-
bitiOn that she gave of any physical dis
order was the inability to swallow with
out causing a sDasm in the esophaguS.
1t was only slight at first, but it soon
became so marked and painful that she
had to give up eating naturally alto
gethei, and took her food entirely in
LIQUID form through a tube, which
when occasion required. was put
a short distance into the esoph-
agus This answered the pur-
pose for time. and then new diff
Guilty appeared. The fluid which passed
through the tube did not run into the
stomach, but simply filled the esophagus
and remained there until it was drawn
Off with vacuum syringe. A plunger
was made slightly larger than the
esophagus, and an attempt was made to
force the 1000 into the stomach against
the obstacle or upward pressure, using
the esophaguS as the cylinder OF a
pump. This could be done, but 1t re-
quired a degree If force that rendered it
Absolutely Unsafe,
AS the esophagus was Liable to burst at
any time and empty its contents into
the throat, and cause death before any
relief could be given. The nature of
the trouble was not definitely known,
but it was believed that any substance
put into the eS0phaguS would produce a
spasm and close the tube by strong
contraction at the place where it joins
the stomach. This was only conjecture,
but it was certainly plausible. and on
the same principle that sudden change
of temperature in the air will. in an
asthamatic patient. cause a SpaSm0dlc
action of the Windpipe and close it en-
trelY.
Life was supported in the patient by
nOuriShment given per rectum. but, as
it was only a question OF time when this
would fail to restore the daily loss of
tissue and strength, it became evident
that more energetic method OF treat
ment had to he devised. Gastrotomy
was finally decided upon, and the pa
tents system was toned up for several
days by stimulantS prior to the opera
ton. Every other organ in the body ap-
peared to be perfectly sound save the
stomach, and ether was freely
given. An incision was made
ill the abdomen in the left
side just below the ribs. The greatest
care was taken by DR.. Donlin to divide
the tissue evenly and to cut the perito-
neum without making a ragged edge.
The opening was made large enough to
handle the stomach easily, which organ
was unusually small and much higher
in the abdominal space than it is gener-
ally found. The surgeon Introduced
his fingers into the wound, seized the
stomach and drew 1t partly outside the
body.
A Small Incision
was made in the stomach while it was
held by an assistant. and through this
the surgeon passed flexible probe.
The probe came to stop when the end
of it reached the cardiac Oritice, which
indicated that there was a permanent
obstruction located there. Nothing was
done with this until later. The incision
in the stomach was enlarged to about
an inch and half, and the organ was
pushed into the abdomen until the edge
OF the inciSion in it was even with the
incisior in the abdomen. The stomach
was then returned to the abdomen III a
position which would admit of it's being
easily reached from the outside after
the wound healed. This made a round
opening into the stomach about an inch
in diameter, through which TODD could
be passed.
A second incISion was made in the
median line in the abdomen, below the
breaSt-bOne, and the tissue was divided
carefully. The stomach was reached
through this opening at its upper end,
and admitted of an examination of the
| cardiac orifice. 1t was found that a
| muscular ring had been formed III the
esophagus. Just above where it is Joined
to the stomach, similar to the band that
| sometimes grows around the intes tines
! ard prevents the passage OF forces.
| This ring had contracted so that it
| closed the passage into the stomach.
| There was a chance, if this ring was
taken out, that the stomach in time
| might be restored to its normal condi-
ton, and the surgeon deemed it adyiS-
able to
Give it Trial.
The esophagus was drawn to the alb
dominal opening and the little band
was cut out. The end of the esophagus
was then stitched to the cardiac Orfice
and the abdominal wound was closed.
The patient rallied from the terrible
shock of the operation Splendidly, and
for twenty-four hours appeared as if
sine were going to make good recovery.
Then she had relapse and sank into a
comatose state. Heart complications
appeared and only a portion of the
blood was expelled from the organ at
each beat. while what was left was
churned back and forth from the aorta
to the heart Every known Stimulant
was given to the patient to increase the
hearts power so that it could force the
blood through the body without bene-
| fitting the patient. The heart symp-
toms were due, it was believed, to the
loss of the patients vitality and
strength, and unless these could be re-
| stored there was no chance of the pa