History of medical practice in Illinois - Bushnell Historical Society

168 History of Medical Practice in Illinoiswas found, and the patient refused to permit nephrectomy. (The anesthetic,if any, was not stated.) The patient, however, obtained complete relief ofsymptoms after operation!Colles' fracture was discussed. An autopsy had been performed on awoman who had died following a fall from a window. Excellent anatomicaldescriptions of the wrist were made, and the author supplemented this bysome experiments on the arm of a cadaver. He concluded: "The autopsyand subsequent experiment render it evident that we have, in the injuryusually known as Colles' fracture, not a mere break of the bone, but a luxationto deal with." For treatment he suggested that the patient may or maynot be etherized. A method of reduction similar to that now in vogue wasminutely described. Dr. Gunn then described his method of reducing dislocations,citing a case involving the distal phalanx of the thumb. Hismethod was "to place the dislocated member as nearly as possible in theidentical position which characterized it at the moment of escape from thejoint." The joint should then reduce easily, quickly and quietly. Dr. Gunncontinued: "A well developed laboring man, with a dislocation of the terminalphalanx of the right thumb backwards and outwards, which had occurredfive hours previously, was seen by several medical men who had unsuccessfullyessayed a reduction. Amongst these Irecognized at least oneexpert surgeon. I also made the attempt, after the usual manner of reducingphalangeal dislocation, and though extreme effort was made, I, too, was unsuccessfulin first attempt. A little reflection recalled the fact that the tendonof the long flexor is inserted into the anterior surface of the very base of thephalanx and that from its position in the dislocation, it (the tendon) mustbe hooked around the side of the head of the first phalanx; while from theproximity of that portion of the tendon which was in constant contact withthe side of the head to the front of insertion in the luxated bone, all ordinaryefforts at reduction only more forcibly hooked the tendon in its abnormalposition. I determined to act upon this view of the case, and, soconfident did I feel in the correctness of my position, I determined to takehim before the medical class for the trial. Seizing the first phalanx with myleft hand, with my right I carried the luxated bone still further outwards,then forwards and lastly inwards, all by one semicircular motion, by whichmeans reduction was almost immediately accomplished." Dr. Arthur D.Bevan, later Professor of Surgery at Rush Medical College, who had beenone of Gunn's assistants, taught this method all through his teaching career.It was a great contribution to dislocations by this Illinois surgeon.1871Dr. Andrews was chairman of the Committee on Surgery. Dr. Princereported again on plastic and orthopedic surgery. A new method of operat-