The Houston daily post. [volume] (Houston, Tex.) 1886-1903, 1896-01-26

pens for reasons not of very satisfactory
explanation, disposition on the part of
apparently unniured tissue adjacent to
the injury, to Jecome grangrenous and
slough away. An injury then presenting
the same degree of pathological distress
due to other causes will usually yield to
conservative treatment more readily than
those under description, BECAUSE
|. Less liable 10 septic infection.
.. Less bruised and presenting less posi-
tive damage to the nerve and circuatory
supply.
3. Less liable to sloughing of adjacent
tissue.
II having hoen decided that an ampnta-
ton is necessity and the time having
arrived when it appears opportnne, the
matter of location is of final
and special importance, Here again
the location must be determined in
reference to the character Of the injury
and the manner of its production. The
general law applicable elsewhere, that the
mortality IS in proportion to the nearness
to the body holds good here only as IT
relates TO the immediate result, but must
be ignored in some measure on account
of the tendency of adjacent parts to be-
come gangrenous as indicated above. In
order that one operation succeeds expert
ence seems to show that a higher point
must be selected than if the hurt was
from other causes. Just why gGngreae
is likely in the contiguous tissues after a
railroad injury has not to my mind been
very satisfactorily explained. but I Is. |
take 1t. a matter of common experience.
that faps. when cut Immediately through
or very near the wound, most frequently
slough, rendering the patient liable to n
suppuratinG wound, and possibly making "A
secondary operation necessary at time
when the patients constitution is not so
IN he h1uirpinp Whether nc
has been thought, the sangrene condition
follows as sequence of tho general
shock or because the tissues. subjected to
sudden and great pain IN their contrac-
tons. compress themselves upon those vos-
sells supplying the nutritive blood, is of
little importance, except theoretical, but
to remember the fact as a guide Is OF
practical concern,
REPORT OF A CASE OF PERIosTIAL
REPRODUCTION or BONE-By Or. A
Bailey Company Surgeon, c., C.. and S.
Fe Railway, Richmond.
Gentlemen of tine Association: have a
case to report which may be of some In
terest / will not enter into a long discus
sion about resection or eXcission ANA the
possibilities of reproduction of bone by
the periostium. There has been for some
years a doctrine that section of bone
be left intact the continuity OF the bone
viii be restored. l read an article. how
ever. in the Railway Surgeon which, II
seems, endeavored TO disprove this doc
trine. My case is evidence in point TO sus-
tain the doctrine. About the 18th OF March
| received a note from pr. Rich asking
me to come seven miles In the bottom
| prepared TO amputate. Upon arrival
| found Lige c., negro, suffering from a
| gunshot wound OF the right arm. The CUR
was so near the arm that large hole
| was made by the shot and about foul
| inches Of the upper and middle thirds q
| the numerous was commnuted, several
| of the shot passing through the entire
| arm, a few entering the right breast. Al
| Ter chloroforming the patient / proceeded
| 10 enlarge the wound sufficiently TO clear
| away the shot and comminuted bone
which was tedious. There was ono large
fragment which ! have in by hand This
| fragment was held intact by perlostium
| renoyed the bone. leaving the periostium
intact. The wound was then dressed with.
49,, sutures. on the third day 1t was
Srassad again. / then found there had
,aer considerable powder burn, not alone
- he skin, but OF the muscle. fascia, etc.
u.hscb neeessitated sluffing and healing
~, r,ranuIation. For a few days the dress
80 we're without splint. when spiints
80 used The weight Of the arm In q
| ~. a,s,vered the purpose OF extension