Forty years in the medical profession, 1858-1898 / by John Janvier Black.

  • Black, John Janvier, 1837-1909.
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: Forty years in the medical profession, 1858-1898 / by John Janvier Black. Source: Wellcome Collection.

    57/506 (page 53)
    and through again. The dressings and bandages completed the operation, most beautifully and thoroughly done. I saw something of the after-treatment of this case with Maury. There were no soiled towels or dressings lying around, I assure you, when the old gentleman was expected. The man made a good recovery. The next case was Agnew’s, at the clinic of the Pennsyl¬ vania Hospital. I think Pancoast was in Europe then, but Gross and many of the other surgeons of the city were on hand. This case was an elderly man who had been to some extent a drinker. His vessels were somewhat hardened, which made the case a little unpromising. It also was a case of sarcoma, and was no doubt an operable one. The day before, Agnew had laid out the line of his incisions for the flaps by tracing them with a dampened stick of silver nitrate on the skin. He had the limb raised at right angles to the body and massaged, to empty the vessels, and applied a band¬ age. This was particularly well here, for there were some varicose veins below the knee. Next he applied the abdomi¬ nal tourniquet, as was done in the other cases. When every¬ thing was ready, he took a large scalpel in his hand. Agnew was ambidextrous, and it made no difference to him which he used. He made his skin-flaps anteriorly and posteriorly, following the lines already laid out. These finished, he opened the sheath of the femoral vessels and tied both artery and vein; then with a catling he completed the operation by making short anterior and posterior flaps of the muscles, and lastly disarticulated the bone. There was no hemorrhage. The operation was completed by tying off the vessels remain¬ ing, stitching the flaps, and applying the dressings. The man did well until about the tenth day, when he died of secondary hemorrhage, a result not altogether unlooked for, and from no fault of the operator either during the operation or during the after-treatment. The operation was beautifully done, exhibiting that care and attention to detail for which Agnew was always noted. Two out of three cases successful was a wonderful record in those days before asepsis and antisepsis