of international asylum for the mutilated. I may safely say that I have examined fifteen thousand stumps, and at the present time every form of new amputation is pressing on my attention. While I regret to be obliged to repeat that I have not yet seen a case of Syme's operation which has admitted of such an artistic appliance as is satisfactory to myself (some have been satisfactory to my patients), I yet hope to meet the requirements of this operation more successfully, so as to aid the surgeon to the uttermost, in suiting his place of election to the indications of natnre, in all cases. But science and art, now wedded, must not be divided. If the surgeon considers not wisely the form of artificial appliance most serviceable to his patient, his error will be irreparable; so will be the mechanician's, if he possess not a knowledge of the living (as well as of its imitative) mechanism. My researches are not confined to invention as yet. With the aid of our great surgeons of Philadelphia, to whom I am greatly indebted, I am exploring the mysteries of the cadavera (as well as the books) with reference to these new modes of operation. Dr. Pancoast has furnished three Pirogoff stumps for me, one of which I have treated successfully, and I have reason to anticipate better success still with the others, the stumps being better. It will be understood that I am now instituting no comparisons between these cases and those amputated at the points of election above the ankle, as before submitted. That I can do more intelligently after a reasonable trial, in a nnmber of the best cases, which so consummate surgical skill will certainly offer me. Pirogoff's is, without a doubt, the best ankle operation now practised. I have just devised an improved foot for this operation, (which is also adapted to Syme's) and if it shall prove as perfect in action as it appears in theory, it will remove many of the objections to these long bulbous stumps. "The ankle disease seems to be contagious, and has exercised my mind, hand and foot, till I, too, am halling between two opinions. What will you say if I propose a new mode, better than Pirogoff's? I do not say that I can, and yet I have an idea which the first surgeons of our city have told me is worthy of consideration. I now give it to you. It may, like many other pretty theories, prove simply impracticable. I am not aware that it has been tried. My mode consists in a horizontal (instead of a vertical) division of the os calcis at the margin of its upper articular surface, and may be briefly sketched as follows: "Make a curvilinear incision around the foot in front, from the lower part of one malleolus to the other, dividing the tissues a little lower than is usual in performing Syme or Pirogoff's operation, and round the sole, making the plantar flap long enough to meet the dorsal above the division of the bones. Dissect up a little above the ankle joint, then down around the astragalus, to its articulation with the calcaneus; remove the astragalus, and divide the tibia, fibula and os calcis horizontally, removing the entire articulating surfaces of the two former. Now remove the calcaneo-astragaloid surface of the calcaneus, and place the cut edges of the bones in apposition, adjusting the flaps so that the cicatrix shall be above the incision of the bones. The calcaneus will be removed upward and forward about an inch, its centre being in a vertical line with the tibia, as seen in the sketch. Fix the knee, and bandage from it round the heel, if necessary, to hold the bones in place while uniting. "This operation will shorten the limb an inch or more, giving space for the contraction of the muscles, and rendering the division of the tendo-achillis unnecessary. It admits of a suitable ankle joint in the false foot, and retains the entire base of the os calcis and its integuments intact, and in the true line of support indicated by the centre of gravity, thus affording a broader and better base of support in the false foot, the arch of which is made to fit the calcaneus just as the shank of a well formed boot fits an unmutilated member-perfectly comfortable, I think." NEW ORLEANS Medical News and Hospital Gazette: A MONTHLY JOURNAL, EDITED BY D. WARREN BRICKELL, M. D., Professor of Obstetrics, New Orleans School of Medicine; Visiting Physician, Charity Hospital: E. D. FENNER, M. D., Professor of Theory and Practice in the New Orleans School of Medicine. Terms, $5 per annum, payable invariably in advance. Original Communications. PAGE. 889 Clinical Reports of Cases observed in the New Orleans Charity Hospital, ........ 904 An Item in the History of Quarantine. Extracted and translated from Prof. Special Selections. 911 913 The modern Treatment of Stone in the Bladder, and its Results 914 Editorial and Miscellaneous. The End of Volume VI.... 923 Annual Report of the Board of Health to the Legislature of Louisiana, 924 Hygienic Treatment of Diabetes Mellitus, or Glucosuria..... An Analysis of Two Thousand Consecutive Cases in Midwifery. Statistics of Four Thousand and Forty-nine Cases of Midwifery.... Chronic Inversion of the Uterus End of the Black Doctor's Career 942 947 Treatment of Spina Bifida by Injections of Iodine.... Treatment of Ascarides Improved Method of Examination of the Ear Surgical-A new Foot Amputation COLLEGE HOSPITAL --- Ꭺ Ꭲ -- BROOKLYN, N. Y. THE First Course of Lectures in this Institution will commence on THURSDAY, T MARCH 29th, 1850, tures this sixutiEN WEEKS. USTIN FLINT, M. D. (New Orleans School of Medicine), Professor of Practical Medicine and Pathology. RANK H. HAMILTON, M. D. (University of Buffalo), Professor of Surgery. JAMES D. TRASK, M. D., Professor of Obstetrics and Diseases of Women and Children. R. OGDEN DOVEMUS, M. D. (New York Medical Collegs), Professor of Chemis try and Toxicology. JOSEPH C. HUTCHISÖN, M. D., Professor of Surgical Anatomy and Operative Surgery. JOHN C. ĎALTON, M. D. (College of Physicians and Surgeons, Ny York), Pro fessor of Physiology and Microscopic Anatomy. DE WITT C. ENOS, M. D., Professor of General and Descrip atomy. erapeutics. The opportunities for Clinical Instruction are equal to those furnished by any College in the Union. College Cliniques will be held regularly throughout the session. Nearly 10,000 Medical and Surgiaal Cases have been prescribed for at the College Hospital (which is under the same roof with the Lecture Rooms) during the last eighteen months. Students can also enjoy the Clinical advantages afforded by several large Hospitals and Dispensaries of this City and the City of New York, Dissecting material is abundant. The subjects will be so prepared that Practical Anatomy may be studied as well as at any other season of the year. FEES. For the Whole Course, including Matriculation and Hospital Graduation Dissecting $100 20 5 Good board and lodging can be had for $3 to $5 per week. Further information may be obtained by addressing any member of the Council or Faculty. BROOKLYN, N. Y., December 24th, 1859. |