History of medical practice in Illinois - Bushnell Historical Society

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1 60 History of Medical Practice in IllinoisMechanical Lesion of the Knee Joint" by a circular saw through muscle,patella and condyle of the femur. Under chloroform part of the patellawas removed (the first patellectomy recorded in the state). Blood waswashed out of the joint which was closed with interrupted stitches, andcold water dressings and splint applied, in spite of which suppurationfollowed. The joint was drained several days later, the patient this timebeing under the influence of brandy. The patient recovered; nine monthsafter the accident he could walk without crutches.1858The Committee on Surgery consisted of Drs. Edwin Powell of Chicago,A. D. Stephens of Vandalia and A. H. Heise of Joliet. Dr. J.W. Freer ofChicago sought the appointment of a committee on "The Treatment ofAnchylosis by Forcible Rupture" and presented a new dressing for treatmentof fracture of the clavicle, using adhesive tape.l8 59The Committee on Surgery appointed this year consisted of Drs. Brainardof Chicago and Dr. V. D. Howell of Aurora. Dr. C. B. Johnson of Chicagowas President and his address was on "Human Dissection." He stressedthe absolute necessity of anatomical studies as a part of medical education.i860Dr. David Prince of Jacksonville was President of the State Society. Hisaddress covered the legal relations and responsibilities of the physicianand the surgeon on account of numerous law suits brought against them.He cited two cases. One occurred after a crushing open fracture whenamputation was performed. Later the leg was disinterred and became thebasis for a suit for damages (malpractice). In the other instance the surgeontried tosave a leg under similar conditions but the limb, when healed,was shown to be \/2 mcn shorter than its fellow. He was sued by the patientfor the sum of $5000 for not amputating. This suit was finally dropped bythe plaintiff, but the surgeon became so disgusted with human gratitudeand the conditions of practice of the time that he abandoned his profession.Practically all open fractures at that period went on to infection and avery high percentage later to amputation, as there was no antisepsis andno primary control of the wound. This course of events was consideredinevitable.The Report on Surgery for the year was given by Dr. Brainard on thetreatment of ununited fracture, a quite common ailment of the time. Thisreport was epoch-making and is worthy of consideration in detail:
General Surgery 161Dr. Brainard advised a subcutaneous operation by means of agimletor needle, hoping thus to avoid devastating suppuration. He spoke of theearlier use of ivory pegs that had been employed in these 1 ases as interferingwith callus formation between the bone fragment ends. He started 1)\using a small instrument through a minute skin puncture, then makingthree punctures across the non-union in the bone through such a hole.Ten days later, using a longer drill or gimlet, he made more traversingholes and continued thus until some tenderness and heat appeared in thepart. He often required as main as eight such local operations to succeedin finally establishing bony union. He obtained union in 16 out of 17patients of ununited or delayed union of long bones. He also recordedtwo cases of ununited femora in which the bone ends were fixed togetherin open operation by a metallic substance. Both of these resulted in bonyunion but only after much suppuration. He did not recommend the procedurefor ordinary use. He reviewed the known methods employed up tothat date for this condition, citing Malgaigne's method of rubbing thefractured bone ends together, the use of acupuncture needles, setons, ligature,resection, abrasion of fragments and cauterization. He cited Hamilton's"Textbook on Fractures" which advised "the practice recommendedby Brainard, namely, perforation of the soft parts and bone with an awl"and "if in the lower extremity, allow the patient to walk about after theplan of White or Smith." We can understand, therefore, that Dr. Brainardof Illinois not only had a national reputation, but also an influence insolving at least one of the most difficult problems of surgery of his day.Dr. Brainard also reported at this time the wiring of bone ends togetherwith three successful cases, and treatment of malunion after fracture withdeformity by weakening the bone on one side by perforation to soften itin order to permit easy breaking by forcing it back into position with splintpressure. Finally, he described an operation for ankylosis of the knee jointwhich might be considered the first arthroplasty of this joint performedin Illinois.Brainard prophesied that when instruments were found capable of effectinga neat and perfect division of the bone with so little injury to the softparts as not to give rise to suppuration, his method would become obsolete.He had contrived several different kinds of saws to effect this but none hadsucceeded. He related a method of manual reduction of dislocated hipswithout the help of pulleys or other mechanical power then employed. Healso described an operation for ankylosed mandible, removal of jaw sequestra(mostly from mercury poisoning), and removal of parotid andsubmaxillary glands for a scirrhus carcinoma of the parotid which he hadoperated upon in 1857; to accomplish this, he divided the external carotidartery and facial nerve. Finally in his report he gave the technic of an opera-
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HISTORY OFMEDICAL PRACTICEIN ILLINO
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i3 Zvibxxtt to Br. 30. 3L ©abteTHI
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PREFACEVARIOUS members of the Illin
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Prefaceixall of its local health de
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PrefacexiDr. E. A. Piszczek, Chicag
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THEEDITOR'S FOREWORDperiod 1850 to
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Editor's Forewordxvand 650 he comme
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xviiiXVIII.XIX.Medical Bacteriology
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CHAPTER IINTRODUCTIONBy DAVID J.DAV
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Introduction 5Smillie 3 wrote on ep
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CHAPTER IIMEDICAL GEOGRAPHY OF ILLI
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Medical Geography of Illinois 9geol
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12 History of Medical Practice in I
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Medical Geography of Illinois 15had
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Medical Geography of Illinois 17of
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Fig. i. Places and regions in Illin
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Medical Geography of Illinois 21ref
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Medical Geography of Illinois 23Cha
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i„r»-l ll'urlnllli• A i!.n»Ut
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CHAPTER IIITHE HARDY PIONEER:HOW HE
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CHAPTER IVORGANIZATION OF THE ILLIN
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CHAPTER VIIINTERNAL MEDICINEBy GEOR
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History of Medical Practice in Illi
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CHAPTER XIIIOTOLARYNGOLOGYBy ALFRED
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CHAPTER XIVDERMATOLOGYBy B.BARKER B
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CHAPTER XVNEUROPSYCHIATRYBy OSCAR H
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CHAPTER XXIVMEDICAL JOURNALISM IN I
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APPENDIXMISCELLANEOUS NOTESAddition
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5ioIndexAntifebrin, 138, 139Antipyr
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5 1 * Index159, 163, 190, 284; Amer
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5HCollege of Medicine, University o
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516 IndexEpidemics, 5, 507Epileptic
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15 i8 IndexHarris, Dr. J. O., 115Ha
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5 2 ° IndexJacobson, Dr. Daniel Si
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522Index456, 457; Privately Endowed
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524IndexParkes, Dr. Charles T., 181
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3526IndexReed, Dr. Carlos I., 403Re
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5 s8 IndexStrong, Dr. R. M., Histor
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530IndexWright, Mrs. Edward, 479Wri
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History of medical practice in Illinois - Bushnell Historical Society

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