44 THE AMKlilCA.N MU^TIU.V [February, 



consisting of about sixty bcils. These two wards arc counccted 

 by an oporatin*^ ward, containing ten or twelve betls. There are 

 also the necessary ailniinistratiou biiildiujijs. 



This hospital is used only lor oju'rations, and patients wiio 

 are wailing their turn to be operated upon. I saw theie asejitic 

 surgery carried out with a perfection of detail, and with such suc- 

 cessful results, that I certainly have never seen ecpialletl elsewhere. 

 I sjiw there six cases of lapan)toniies in various stages of recovery 

 alter being operated upon — cases of cholecvstectoin\ , neph- 

 rectomy, vaginal hysterectomy, aniputations, and inileed all the 

 graver operations of surgery, almost all, as the histories of the cases 

 show, recovering without rise of temperature or supi>uration. 

 They start out in the Hospital Hichat with the assumption that 

 if an operation is aseptically perlormeil by an aseptic operator 

 on an aseptic patient, that there ought to be neither fever nor 

 suppuration following a surgical operation. If rise of tempera- 

 tuie takes place the operator is at once attackeil antl blamed ior 

 imperfect surgery. If an operator has three or four such cases 

 in succession, they have a nickname for him ; he is called cochon 

 sale (in English, a dirty hog). 



Time will not permit me to describe- all the interesting surgical 

 cases I saw. Among them was a case of ligation of femoral artery 

 on account of a traumatic aneurism, caused by erosion anil pene- 

 tration of the artery, by a sharp exostis on the femur. The artery 

 was cut down upon and ligated above and below the injured por- 

 tion, with a successful result. 



Another case was one of necrosis, involving nearly all of the 

 shaft of the femur. After the removal of an immense sequestrum, 

 the cavity was filled up by the fresh and aseptic bone from a calf. 

 This was broken up about as large as coarsely ground coffee, and 

 then the cavity was filled up with it. with the result of the forma- 

 tion of a firm and solid thigh bone. This case was operated upon 

 about six weeks before I saw it, and was about to be dischaiged 

 cured. Another case of a similar kind was awaiting operatioii. 

 Dr. Hartman acknowledged that he had received the idea of doing 

 this from an American surgeon, Dr. Senn. 



On Saturday, August 27, a woman was brought into the Hos- 

 pital Bichat apparently dying, temperature 107.8, pulse scarcely 

 perceptible, and partly delirious. The case was one of suppurat- 

 ing ovarian cyst, which had burst into the cavity of the peritoneum. 

 After wrapping her in hot blankets and administration of stimu- 

 lants, a slight reaction set in and laparotomy was immediately 

 performed. The next morning, at 9 A. M., I saw her and she was 

 rational, pulse nearly normal, and scarcely any fever. It seemed 

 almost like seeing a woman raised fr(jm the dead. 



The inethods of oj^erating are of the simplest character. The 

 arms and hands of the operator and his assistants arc of course 

 thoroughly cleansed with soap and solution of corrosive sublimate 

 1-2000, as well as the part of the patient's body where the opera- 



