Year: 1860

|


We will take quiet post of observation in
the area of the operating theatre at one OF
our metropolitan hospitals, in this year of our
Lord 1860 Notice is posted that anputa-
tion of the thigh will be performed at two
o'clock, p. m, and we occupy our seat ten
minutes before the hour.


! The area itself is small, of horse shoe
form, and surrounded by seats rising on steep
| incline one above another, to the number of
eight or nine tiers From 100 to $50 students
occupy these, and pack pretty closely, especial
| ly on the lower rows, whence the best view is
obtained For an assemblage of youths be-
tween eighteen and twenty-five years, who
have nothing to do but to wait, they are toll
erably we'll behaved and quiet. Three or four
practical jokers, however, it is evident, are
distributed among them, and so the time pass
es all the quicker for the rest.


The clock had not long struck two when
the foldiDg-doors open, and in walk two or
three of the leading surgeons of the hospital,
followed by staff of dressers, and a few pro-
! fessional lookers-on, the latter being confined
| to seats reserved for them on the lower and
| inncrmost tier A small table, covered with


instruments, occupies place on one of the
area water, sponges, towels and lint are
placed on the opposite. The surgeon who is
about to operate rapidly glances over the ia
ble and sees that all his instruments are there
and in readiness. He requests colleague to
take charge of the tourniquet, and with
word puts one assistant to take the faps,"
another to hold the limb, third to hand the
instruments aud the last to take charge of
the sponges.


This done, and while the patient is inhaling
the chloroform in an adjoining apartment, un-
der the care of a gentleman who makes that
his special duty, the operator gives to the now
hnShed and listening auditory o brief history
of the circumstances which led to an incura-
BILE disease of the left knee joint and the Iea-
sons why he decides on the operation about to
be performed He has scarcely closed when
the unconscious patient is brought in By
couple OF sturdy porters, and laid upon the
operating table, small but strong and steady
erection four feet long by two feet wide, which
stands in the centre of the erea. The left be-
ing the doomed leg, the right is fastened by
a bandage to one of the supports Of the table,
so as to be out of harms way, while the dress
er, who has special charge of the case, is seat
ed on low stool at the foot of the table, and
supports the efe. The surgeon who assists,
encircles the upper part of the thigh with the
tournquet, placing its pad over the femoral
artery, the chief vessel which supplies the
limb with blood, and prepares to screw up the
instrument thus to make sure that no cOnsid-
cradle amount of the vital fluid can be lost
| The operator standing on the left side Of the
corresponding leg, aad holding in his right
hand q narrow, straight knife, Of which the
blade is at least ten inches long, and looks
marvellously bright and sharp, directs his
eve to him who gives the chloroform and
awaits the signal that the patient has become
perfectly insensible. All is silence and pro-
found every assistant stands in his place,
which is carefully arranged so as not to inter-
rupt the view Of those around.


The words "quite ready" are no sooner
whispered, than the operator, grasping firmly
with his left hand the flesh which forms the
front part of the patients thigh, thrusts quiet
" and deliberately the sharp blade horizontal.
ly through the limb, from its inner side, so
that the thigh is transfxed little above its
central axis, and in front of the bone He
next cuts directly downwards in the plane of
the limb, for about four inches, and then
obIiquely outward, SO as to form flap, which
is seized aud turned upwards out Of the way,
by the appointed assistant A similar trans.
|
spot, but the knife is this time carried behind
the bone and, similar ncision follows,
and another fap is formed aud held away
as before. Lastly, with rapid circular
sweep around the bone he divides all left un-
cut and handing the knife to an assistant,
who takes it and gives saw in return, the
operator divides the bone with few more
workman-ke strokes, and the limb is severed
from the body. A rustling sound of general
movement and deeper breathing is heard
among the lookers-on, who have followed with
straiuing and critical eyes every act which has
contributed to the accomplishment of the


task and some one of the younger students
is heard to whisper to his neighbor, Five
and thirty seconds not bad, by Jove y
The operator now seats himself on the stool
Just vacated by the dresser, who has carried
away the leg, and seeks in the cut surfaces be-
I fore him the end of the main artery Oh which


to place lgature. There is no flow of blood
only little oosng for the tourniquet holds
life's current hard and fast Only five min
uteS uncontrolled flow Of the current from
that great artery, now so perfectly compressed,
and our patients career in this world would be
closed for ever. How is it permanently held
in check 4? and what have we to substitute
, now for the Kissing sparkling, and sputtering


iroD and the boiling pitch? The operator
{ takes hold of the cut end of the artery with
! a slender, delicately made pair of forceps,
and draws it out little, while an assistant
passes round the end to draw out ligature OF
very fine whipoord, fine but strong, and care
fully ties it there with double knot and so eff
fectually closes the vessel. A similar process
is applied to perhaps six or seven other but
, smaller vessels, tourniquet is removed, and nc
T bleeding ensues. Altogether, the patient has
e lost little more than half-a-pint of blood. The
S flaps are placed 10 opposition, the bone is vel