The Detroit times. [volume] (Detroit, Mich.) 1903-1920, 1914-09-30
.stnsd tAs ..Dath0lOsy O the Nv

+ IL Is not generally known that the
! United States Is fast becoming ecu
ter OF surgical teaching TO which the
Old World must come II II would view
the masters at their daily tasks. The
work of the great American sur
geons IL as well known In Europe az
Il II here, and the great ambition OF
every Aspirant and Diensthabender
Assistant Ii to come TO America TO
see how IL IL done.
Two questions are invariably ask
ed Of all American visitors TO the far
mous European clinics: DO you know
the Mayo brothers, and Have you
seen Cushing operator These are
NOTABLY the men who have contrib
uted to the extension OF clinical sur.
gerry by deyising new operations and
pushing ever further outward the linn
liting bounds Of surgical technique.
or destroyed kidneys.
One OF the most interesting and fm-
portant emergency operations Ii sur
gerry OF the heart. This Is extremely
hard to carry out In field hospital.
lowing to the difficulty OF obtaining
rigid asepsis, the number OF assist
ants required and the exactiag tecf'-
nique.
Recently Or. Francis Stewart Of
Philadelphia reported Ave cases OF
suture OF the heart. His hrst case
was q stab wound OF the left ven
tricle. three-quarters Of an inch long.
DR.. Stewart opened the chest and
sewed the heart with q continuous
silk suture, The area become infect
led, but the patient recovered and
died Ave years later of pulmonary
tuberculosis.
| One OF the difficulties In heart sur
gerry II the formation OF clots In the
wounds or In the heart itself. These
are exceedingly dangerous. because. II
swept into the circulation. the patient
dies a. II shot by bullet. There 10
also the further difiiculty OF sewing
structure that In under constant mo-
ton. This calls for very rapid. GER
tain work.
Now Sew Up Stab Wounds.
Since sewing stab wounds OF the
heart has become general the NOR
ltality Is now only 80 per cent. as
against So per cent In 1867. The d.
agnosis 10 sometimes difhcult. but In
large st. Petersburg hospital II was
made In eleven out Of twenty-one
cases. The operation consists In en-.
larging OF the wound In the chest,
removal Of the underlying ribs and,
while the heart 10 fixed by a finger,
silk threads are passed through the
heart sac and heart muscle and tied.
The wound Ia then lightly packed
with sterile gauze to secure drainage
The results are sometimes striking
In that no irregular heart action or
adhesion ensue.
another modern feat Ii amputation
OF portion Of lung. One year ago
Sir William MacEwen demonstrated
q case before the International Con-
gress Ut Surgeons In London which he
had operated upon Is years before.
At that time the entire left lung had
been removed for tubercular disease.
The man Is now strong and healthy
and 10 at his work daily.
II Is entirely possible that in gun
shot wounds of the chest the surgeon
can 60 In. tie of the bleeding areas
and excise the destroyed portion Of
the lung. To do this Will require that
the lung be kept expanded by means
Iof positive insuffation." That. IL
carried out by passing tube into the
windpipe. attaching q bellows and
keeping up a constant pressure of
air so that the lungs do not collapse.
Blood TRANSMISSION Ia one OF tile
most important OF all surgical meas
ures in wartime. The eminent DR..
Alexis Carrel Of the Rockefeller In.
stitute Is now at the front with the
French army and has already report
ed some successful results. He
writes:
Il am seeking men ready literally
to give their blood for TRANSMISSION to
wounded soldiers. Already have
found q doctor and an attorney and
hope soon TO have several others"
The difficulties attending transfu-
sion are very great and the opera
ton requires the most delicate and
exact technique. Nevertheless, In the
hands Of an expert like DR.. Carrel II
Ii a procedure capable OF saving In
Vulnerable lives.
Broken bones, due to falls. spent
shells, etc.. have cost many lives In
former wars. Whereas the old-time
surgery demanded an INFINITE amount
of time. patience, the prolonged use
OF plaster Of paris casts, ETC., we now
have q method, thanks to the emf
nent surgeon, Mr.. Arbuthnot Lane of
London. by which we can "cut down"
on the broken fragments and splice
them together by means Of plates
and screws. The healing time IL
thereby very much shortened and the
results are far better than by the old
setting" method.
Abdominal wounds are source Of
special worry to the army surgeon
1t IL still great question how they
should be cared for, but In general
all authorities are against probing
for the bullet. II the bullet has. not
penetrated vital organ--stomach, In
testines, liver, kidneys. etc.-it can
do no great harm, and II u therefore
best to treat the patient "expectant.
ly"--that is, to watch for any, sudden
change of symptoms and be prepared
to operate promptly.
The x-ray IL Of course indispens.
able for locating the bullet and help
ing to Judge OF It's probable course.
Lacerations Of the organs mentioned
call for immediate operation. and In
such cases the principle Of anoci-as-
sociation propounded by DR.. Grille of
Cleveland, O., helps greatly TO ward
OF and reduce so-called shock"
DR.. Grille. az soon as the abdomen
IL opened, applies q local anaesthet-
&c such as cocaine or novocaine to
a n. xY