Bismarck daily tribune. [volume] (Bismarck, Dakota [N.D.]) 1881-1916, 1906-11-22
THE SURG ~ NJ TOOLS

|THEsURG & 0 N s TOOLS
las FEW AS POSSIBLE USED Nv THE
MODERN PRACTITIONER
no Remove nm; Appendix, For In-s
a stance. He Can Carry Every thing
/ Necessary In One or HIS Packets.
i Hand Forged instrumental the Best.
IA surgeon used to carry d Bag of In
jstruments weighing often MS much us
TWENTY-FIVE pounds when he was called
Ito operate, said a member of tile stair |
of the New York Postgraduate Med
hcal School and Hospital the other day.
To-day an average operation, such as
the removal Of an appendix, calls for no
more instruments than can be carried
fin the pockets.
1 II have Just come" continued the doc
tor, from removing an appendix, and
here in this small package are all the /
instruments / used-a scissors, two ar
ltery clamps, two forceps and q needle
~
ienteric, gynecolog icals and those that
have to do with nes-require more
Instruments but modern science de
1mands the use OF as few as possible in
order that time may be saved. Skill
and haste are prime factors in an ops
leration. In the old days. before anaes-s
lthesia was known, this was to shorten
the patients agony as much as possible.
After ether was discovered surgeons
for awhile operated more leisurely, but
soon finding out that the shock to the
patient remaining under ether so long
twas always dangerous and often fatal
they again recognized the Importance
5!of swiftness. Diminishing the number
lof instruments was one OF the methods
Ifor saving time. In the operating room
i'm the old days there was always, no
matter what the operation, a good sized
table laid out with ten or fifteen score
Iof instruments, fifty artery clamps,
scissors, forceps and lancets by the
dozen. It used to take over an hour to
remove an appendix; today the average
Lis about twelve minutes. s 4
The variety of instruments increases
every year as surgeons meet with new
needs or solve old problems. In our
school here, as in others, many instru-3
timents have been devised Especially
ito ihose having to do with the eye, ear,
nose and throat have we made Yalua-
I'ble additions as well as in the field Of
Iiorthope appliances. The Hippocrat-
lie oath precludes the patenting Of any
Itsuch inventions; consequently all in
Iistrum are free to be made by all
and every surgical mandatory =
The making OF surgical instruments
lin the United States is nearly scontem
liporaneous with the beginning of the
ltrepublic and one or two Of the promE
hent firms today date from long before
THE civil war. In no country are finer,
instruments made than IN the United
States. Though the number Of men
i employed is small every man Is a.
1 skilled iaborer and an artist, with an
aiadro4tness often as fine as that OF al
fljourneyman jeWeler, capable Of maxi
ing even the most delicate Of the great
variety of instruments, amounting to.
l4about 40, 600, which q surgical house
1 must keep ID stock or be ready to pro-
4 duce upon order ~
l Cast and drop forged instruments
i have no lasting value, and once the
edge is worn off they can never be sat
i isfactorily resharpe ned. The process
which they undergo demands that they
slsbe brought three times to white
i heat. The first time the steel becomes
tempered; the second and third time it
i becomes decarbonized and loses its
temper, the result being an instru-
ment with a shell Of hard steel, eapa-
4 bile OF taking fair edge, but beneath
which the metal Is soft and unfit to
stand honing
All good instruments are hand
4 forged. Thus prices are doubled md
iltrebled over the prices OF cast iIlstru-
4 fments because Of the skilled labor and
a time necessary to their constrEction
The workman in a careful factory
must make a study OF his work and
learn the physical qualities Of the
n steel or metal lie works viii, its
i strength and cutting and tension quail
a tiles. General operating Instruments
are made Of steel, silver, platinum,
8 gold and aluminium. German steel,
4 owing to Its tenacIty. IS used for for
ssceps and blunt instruments: English
cast steel for edged tools, as II receives
laa high temper, q fine polish and re-
tains Its edge Silver when pure lis
very flexible and Is useful for cathe-
tiers, which require frequent change of
curve. When mixed with other metals,
a ms coin silver, 1t makes firm ca theters.
81 caustic holders and cannuIated work
Il Seamless silver Instruments are least
b liable 10 corrode. Platinum resists the
Z action Of acids and ordinary heat and
4 is useful for canstic holders, actual
4 cauteries md the electrodes of the
galyano eautery. Gold, owing to Its
/ ductility. Ii adapted for Hne tubes,
such as eye syringes and So forth.
4 while aluminium Is By Its extreme
4 Iightness suitable for probes, styles
Il and tracl1eotOlny f,Ibes ss KS