The morning call. [volume] (San Francisco [Calif.]) 1878-1895, 1891-07-20
PUZZLED THE DOCTORS.
They Thought 1t Shamming, bnt
He Had Tuner.

There was case recently at Bellevue
Hospital that DIR. Bardslee pronounced to
be one OF malngering, which acted like a
boomerang and slapped the doctor in the
face when he least expected it. The natl
ent is Robert Wardell, an cffeminate man.
he had the woman's heart of the ancients
and showed more affection for his own sey
than for women.
He was attacked with hysteria, disease
that belongs exclusively to women.
Though his lungs were normal, his breath
ing was shallow and very rapid. There was
some trouble with the heart. The entire
left side was paralyZed and his whole body
was without sensation. He had frequent
attacks of commissions, and would lay for
hours in comatOse condition, when no.h-
ing known in medicine could arouse him.
The strongest galvanic current thai could
De gwen safely Ii:ade the muscles Jerk and
twist as if they would break away from
their attachments, but the coma was Just as
marked.
The brain symptoms Indicated that thers
was pressure of some sort on the right
side OF the brain, probably tumor which
was growing. These might have made the
hysteria- 1t was decided by Dr. Bardsiee,
alter consultation, that the case warranted
surgical interference. The patient was
given ether, but the heart failed after a few
WINS ilUtH tLutI. OdT6 UdI Daen JlkGu
ana cocaine was injected into the scalp for
several inches. 1t was kept cOpfinei in
circle by an elastic band, so that the anes-
thetlc properties would not be diffused. An
lncislon was made in the scalp and the skull
exposed. An opening was bored through
the bone with trephlne an inch
and a half in diameter and the but
ton of the bone was removed. The brain at
this point was healthy. Then the surgeon
went on hunt for disease. and eight holes
were made in different parts of the skull.
AT every spot the brain was found 10 be in
good condition, and the surgeon was puz-
zied. The brain was probed into at the
large hole to the depth of two inches. Tine
tissue was unusually soft AMI watery. but
there was no tumor. Daring the entire
operation the head was bathed in cocaine
and the patient only complained of pain
once. This was when one of the pieces Of
bone was torn from the dura matter. All
the buttons of bone were returned to the
places that they had been taken from, and
the head was bandaged with antiseptic
dressing. Every one OF the pieces OF bone
united.
Shortly after this there was palpitation
noticed in a swelling in the neck, an omn-
Gus sign. indeed. The swelling rapidly IN
creased, and there was every evidence of
an aneurism. The doctors had been badly
fooled before and this time they waited
until there conld be no chance of mistake.
Inc aDeuriSm became well marked in the
course OF month. The patient had a
sudden and severe attack of dyspnnl, ac-
compamed with nausea, ringing in the ears,
flashes of light, vomiting and great cyauosis.
A very speedy operation was indicated
either to kill or cure the patient.
For the first time in surgery an operation
upon the chest was performed without the
use of ether. 1t c0nld not be given, but the
surgeon was just as bold in cutting as if the
patient was under the influence of ether.
The whole chest was injected with cocaine
at short intervals, and the surgeon made an
lncislon in the left side of the neck on tho
line of the collar-Done. The muscles were
divided and the carotid artery was exposed
and tied as low down as possible. When
this had been done the patient had conyul-
sion and sank into a state of coma. The iu-
1ectionS of cocaine were continued merely
as matter of precaution.
The breast was opened below the collar
bone and the ribs cut through close to the
sternum with chain saw. This was very
delicate task, as the arterial tumor was so
large that it pressed against tile ribs and the
slightest slip would have been fatal. The
ribs were elevated and there was a tumor
-ound in the subclavian and innomi-
nata arteries. Around each of the
Irterles was a band that reSem-
oiled rubber. This was separate from
the arteIial sheath. 1t was cut and taken
out. Then q llgature was put around each
of the big arteries and securely tied. Heavy
catgut WAS used. The heart was very much
disturbed This had been expected and
large quantity of stimuIants was injected
into the muscles of the chest The ribs
were forced into place, and were held by
new bOne-cement invented by DIR. Barislee
This cement sets as soon as touched by
fluid. and it held the bones much firmer than
splint. The wound healed quickly, the
clots in the arteries were gradually alb
sorbed, and the aneurism was cured. This
is one Of the operations that only modern
surgeons wOQld dare attemDt and tina taYt-
books arc all against.-N. Y. cor. Cincinnati
Enquirer.