The Olneyville times. (Olneyville [Providence, R.I.]) 1887-1917, 1906-08-17
THESURGEON'S TOOLS
AS FEW As POSSIBLE USED BY THE
MODERN PRACTITIONER.
To Remove an Appendix, For In
stance, He Can Carry Everything
Necessary In One of His Pockets.
Hand Forged Instruments the Best.

"a surgeon used 10 carry bag OF In
ttruments weighing often as much as
twenty-five pounds when he was called
Of the New York Postgraduate Med
ical 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
I'm the pockets.
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
terry clamps, two forceps and needle.
Many operations, of cOurse-gastro-
enteric, genealogical and those that
have to do with bones-require more
instruments, but modern science de-
mnnds the use of as few as possible in
order that time may be saved. Skill
and haste are prime factors In IN OPP
Grafton. In the old days, before anaes-
thesia was known, this was TO shorten
the patients agony as much IA possible.
After ether was discovered surgeons
for awhile operated more leisurely, but
soon finding out that the shock 10 the
patient remaining under ether so long
was always dangerous and often fatal
they again recognized the Importance
OF swiftness Diminishing the number
Of Instruments was one Of the methods
for 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
OF instruments, fifty artery clamps,
scissors, forceps and lancets by the
dozen. II used TO take over an hour TO
remove m appendix; today the average
IL about twelve minutes.
'The variety Of instruments increases
every year as surgeons meet with new
needs or solve old problems. In our
school here. IA in others, many instru-
ments have been devised. Especially
10 those having to 90 with the eye ear,
nose and throat have we made valua-
BILE additions as we'll as In the field of
orthopedic appliances. The Hippocrat-
tc oath precludeS the patentlng of any
such inventions; consequently all in
struments are free 10 be made by all
and every surgical manufactory."
The making Of surgical instruments
In the United States is nearly contem-
poraneous with the beginning of the
republic, and one or two Of the promi-
nent 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
employed is small, every man is
skilled laborer and IN artist, with an
adroitness often ~ fine rs that of
journeyman jeweler, capable of max
Ing even the most delicate of the great
variety OF instruments, amounting to
about 10000, which surgical house
must keep in stock or be ready TO pro-
duce upon order
Cast and drop forged instruments
have no lasting value. and once the
edge Is worn off they can never be sat
isfactorily resharpened. The process
which they undergo demands that they
be brought three times to white
heat. The first time the steel becomes
tempered; the second and third time it
temper the result being an instru-
ment with shell of hard steel, capa
bic Of talking n fair edge, but beneath
which the metal is soft and unfit to
stand honing.
"An good instruments are hand
forged Thus prices are doubled and
trcbled over the prices Of cast instru-
~, lab IL
time necessary To their construction.
The workman In careful factory
must make n study OF his work and
learn the physical qualities of the
steel or metal he works with, its
strength and cutting and tension quail
tiles. General operating instruments
are made Of steel, silver, platinum,
gold and aluminium. German steel,
owing TO its tenucity, is used for for
ceps and blunt Instruments; English
cast steel for edged tools, rs II receives
high temper, n fine polish and re-
tains its edge. Silver when pure is
very flexible and is useful for cathe-
ters which require frequent change OF
curve. When mixed with other metals.
us coin silver, il makes firm catheters.
cauStic holders and cannulatcd work.
Seamless silver instruments are least
| liable 10 corrode. Platinum resists the
| action of aeids and ordinary heat and
il useful for caustic holders, actual
cauteries and the electrodes of the
! galvano cautery. Gold, owing 10 Its
| duCtility, is adapted for fine tubes,
such as eye syringes and so forth,
while aluminium is by its extreme
| lightness suitable for probes, styles
/ and tracheotomy tubes.
Handles are made Of ebony, ivory,
! pearl or hard rubber. Ebony and rub
bcr are used for large instruments,
| though these at times have handles of
steel. Ivory makes durable and
! beautiful handle, though IL and ebony
nre not entirely aseptic, because it is
! impossible TO boil them for the purpose
| OF sterilization without their cracking.
Ivory and pearl are used for scalpelS
I opt for small Instruments like those