The larger picture of him, copied from a photograph, shows him pulling against a very strong man, and shows the strength of his arm in this horizontal extension or it, as it would be in stopping a four-horse runaway team. Of course, some of the rofary and upward movements of his arm are restricted, because of the loss of the use of some of the muscles, EXHIBIT SIX. RESECTION OF THE ELBOW JOINT FOR GUNSHOT WOUND. NEW APPARATUS FOR EXTENSION AND COUNTER-EXTENSION AT THIS JOINT. Selected from my article read before the American Orthopedic Association, and published in its Transactions of 1888; also published in Medical News of Philadelphia, November 24, 1888: "The management of the elbow-joint, after resection, is a subject that has more or less interested surgeons, and perhaps, the apparatus used in a recent case will commend itself to military and naval surgeons. This instrument is equally applicable to the treatment of inflammatory diseases of the elbow joint in their earlier stages, as after resection. December 7, 1887, Mr. C., a deputy sheriff, while attempting to arrest a desperado near Deer Trail, Colorado, was shot through the right elbow joint, and here are shown the bones (addressing the Orthopedic Association) removed by resection at night by lamp light, assisted by two cow boys, with deputy sheriffs looking on. "The resection was done through a posterior longitudinal cut, which joined the two bullet holes of entrance and of exit. The wound was dressed with antiseptic precautions, my cow boy assistants cleaning their finger nails with a nail brush, and scrubbing their hands and arms in repeated changes of hot water and soap in the most approved manner. The fore-arm and arm were placed in a felt splint, and some hours afterward he was removed to Denver to the county hospital, where I saw him every day or two. Average temperature 99 degrees F." INSTRUMENTS USED IN THIS RESECTION OF THE ELBOW JOINT. Fig. 27. Chain Saw, Retractor, Knife and Forceps. This chain saw has been very useful to me in civil and military practice; is a very small one, made of the best tempered steel by Charriere of Paris, was easily carried in the vest pocket, or in a small pocket case of instruments. For description of brace used after this resection of the elbow joint, see publications mentioned at head of this "Exhibit." The accompanying cut shows the outlines of the brace, but its description is too long for this brief summary. "January 28th, 1888. Wound healed; removed splint. He came afterwards to my office to have passive motion practiced. February 6th: I broke up the adhesions under ether, at the hospital; arm extended during one week in a straight position by means of adhesive plaster, weight and pulley; ice bags to elbow joint." He used this extension apparatus, while in Denver, with the greatest relief and comfort. He made a good recovery. "June 20: I received a letter, probably written by his wife, expressing his gratitude, saying that he was thrown from a wagon, hurting his arm, and that from this accident he had suffered more severely than from the gunshot wound. I have not heard from him since, but when he quitted me, there was good motion in the joint." Some years after this, it was said, he was engaged in herding cattle in Montana, an occupation which requires a very free use of the arms. EXHIBIT SEVEN. OVARIOTOMY. "Messieurs, c'est une audace Americaine, cette operation!" -Piorry. MY SUCCESSFUL CASE OF OVER THIRTY YEARS AGO. At that time this operation was regarded as very fatal, the average of successes then being about one in, probably, four or five, and the operation was much less frequent than afterwards under newer and better aseptic precautions. Fig. 29. The principal instruments used in this operation: a Spencer Wells Trocar to draw off the fluid of the sac, a Knife and a pair of Forceps. |