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Transactions of the Meeting of
the American Surgical ...
American Surgical Association
Library of Medicine
VOLUME THE TWENTY-FIFTH.
RICHARD H. HARTE, M.D.,
RECORDER OF THE ASSOCIATION.
PRINTED FOR THE ASSOCIATION
FOR SALE BY
WILLIAM J. DORNAN, PHILADELPHIA.
Copyright 1907, by Richard H. Hartb, M.D., Recorder of the Association.
NO)' -^ K 1907
701-709 AKCH STREET,
Officers of the Association v
List of Presidents of the Association vii
Fellows of the Association ix
Honorary Fellows .\"^iii
Report of the Committee on Necrology xxv
Address of the President. The Teaching of Surgery. By Dudley P. Allex,
On Spinal Anesthesia. By Professor Kuster 15
Continuous Passive Hyperemia in Delayed Union of Fractures and in Hasten-
ing the Consolidation of Fractures. By John B. Roberts, M.D. . . . ^^
Resection of the Sound Femur in Gigantism and Asymmetry. A Proposition.
By Robert W. Johnson, M.D 40
A New Method of Rhinoplasty by Means of One of the Fingers. By J. M. T.
Finney, M.D 44
Treatment of the Posterior Capsule of the Gland in Thyroidectomy, Based on
375 Operations for Goitre. By C. H. Mayo, A.M., M.D 52
The Results of Radical Operations for the Cure of Cancer of the Breast. By
William Stewart Halsted, M.D. . 61
The Results of Operations for Cancer of the Breast at the Massachusetts
General Hospital from 1894 to 1904. By Robert B. Greenough, M.D.,
Channing C. Simmons, M.D., and J. Dellinger Barney, M.D. . . 80
Carcinoma of the Breast. A Study of the Pathological Conditions and their
Relation to the Question of Recurrence. By Arthur Tracy Cabot, M.D. 103
Report on One Hundred Cases of Carcinoma of the Breast. By John C.
MuNRO, M.D ...112
Report of End Results Following Operations for Cancer of the Breast. By
Frederic S. Dennis, M.D 116
End Results Following Operations for Carcinoma of the Breast. By Willy
Meyer, M.D 126
End Results Followng Operations for Carcinoma of the Breast. By Lfewis
Stephen Pilcher, M.D 133
End Results in Operation for Carcinoma of the Breast. By Albert Vander
Veer, M.D " . . .' 138
Final Results in 164 Cases of Carcinoma of the Breast Operated During the
Past Fourteen Years at the Augustana Hospital. By A. J. Ochsxer, M.D. . 152
End Results Following Operations for Carcinoma of the Breast. By Nathan
Jacobson, M.D i66
The End Results in Operations for Carcinoma of the Breast. By John
Chadwick Oliver, M.D 174
End Results in Operations for Cancer of the Breast. By A. F. Jonas . . 180
Ver>' Late Recurrences After Operation for Carcinoma of the Breast. By
Joseph Ransohoff, M.D., F.R.C.S 187
Clinical Experience with the Law of Accelerating Risk in Cancer. By
E. Wyllys Andrews, M.D 196
Primary- Sarcoma of the Prostate. By Charles A. Powers, M.D. . . . 213
Prostatectomy. By Archibald MacLaren, M.D 222
Further Consideration of the Surgical Treatment of Cancer of the Head and
Neck. By George Crile, M.D 231
Acquired Diverticulitis of the Large Intestine. By William J. Mayo, M.D.
In Collaboration with Louis B. Wilson, M.D., and H. Z. Giffin, M.D. . 237
The Diverticulum Ilei as a Cause of Complete Intestinal Obstruction in a
Manner Hitherto Undescribed. By Frederic Henry Gerrish, M.D. . 255
A Consideration of the Etiolog>' of Certain Cases of Left-sided Intra-abdominal
Suppuration (Acute Diverticulitis). By George Emerson Brewer, M.D. 258
Remarks on the Surgical Treatment of Facial Paralysis and of Trigeminal
Neuralgia, with Exhibition of Patients. By Harvey Gushing, M.D. . . 275
The Desirability of Early Of)erations upon the Nerves in Ischemic Paralysis.
By Leonard Freeman, M.D 284
Fibroid Tumor of the Nasopharynx Removed by Temporar\' Resection of
Both Superior Maxillae (Kocher). By Frederick Kammerer, M.D. . . 293
AneuTN'smal Varix. A Case of Pulsating Exophthalmos, Two Cases of Enor-
mous Dilatation, and One Case of Moderate Dilatation on the Cardiac Side
of the Wound. By George Tully Vaughan, M.D 300
Congenital Dislocation of the Hips. By Oscar H. Allis, M.D 311
Subcutaneous Rupture of the Spleen. By Ellsworth Eliot, Jr., M.D. . 336
Report of a Case of Non-parasitic Cyst of the Spleen. By Thomas W.
Huntington, M.D. ' 366
Four Cases of Rupture of the Kidney, with Remarks upon Conservative Opera-
tive Treatment. By Thomas R. Neilson, M.D 371
A Case of Oidiomycosis (Blastomycosis) with Rapid Generalization, the
Early Lesions Simulating Giant-celled Sarcoma; Death in Six Months. By
Willl\m B. Coley, M.D., and Martha Tracy, M.D 386
Some Considerations in Regard to Brain Surgery. By Stephen H. Weeks,
A Case of Multiple Carcinomata Following Chronic X-ray Dermatit^^s. By
C. A. Porter, M.D., and C. J. White, M.D 41S
OFFICERS OF THE ASSOCIATION,
Elected May, 1907.
WILLIAM H. CARMALT, M.D.
WILLIS G. MacDONALD, M.D.
JOHN F. BINNIE, M.D.
ROBERT G. LeCONTE, M.D.,
1530 Locust St., Philadelphia.
CHARLES A. POWERS, M.D.,
Fourteenth and Stout Sts., Denver, Colo.
RICHARD H. HARTE, M.D.,
1503 Spruce St., Philadelphia.
GEORGE BEN JOHNSTON, M.D.,
ALBERT VANDER VEER, M.D.,
DUDLEY P. ALLEN, M.D.,
WILLIAM H. CARMALT, M.D.,
ROBERT G. Le CONTE, M.D.,
CHARLES A. POWERS, M.D.,
RICHARD H. HARTE, M.D.,
OFFICERS OF THE ASSOCIATION
RECORDER, SECRETARY and TREASURER, ex-officio.
COMIUTTEE ON ANNUAL MEETING
A. J. McCOSH, M.D., JOHN M. T. FINNEY, M.D.,
PRESIDENT, SECRETARY, RECORDER and the CHAIR-
MAN OF THE ADJUNCT LOCAL COMMITTEE
OF ARRANGEMENTS, ex-ojficio.
COMMITTEE ON NECROLOGY, CREATED IN 1884.
(Report by Title.)
F. H. GERRISH, M.D.,
N. B. CARSON, M.D.,
WM. L. RODMAN, M.D.
Place of next meeting:
Richmond, Virginia, May, 1908.
adjunxt local committee of arrangements.
GEORGE BEN JOHNSTON, M.D., Chairmany
GEO. TULLY VAUGHAN, M.D.,
LEWIS C. BOSHER, M.D.
LIST OF THE PRESIDENTS
ASSOCIATION FROM THE TIME OF ITS INSTITUTION.
1880. tSAMUEL DAVID GROSS, M.D., LL.D., D.C.L. OxoN.,
LL.D. Cantab., LL.D. Edin. â€” Founder of the Association.
1883. tEDWARD MOTT MOORE, M.D., LL.D.
1884. tWILLIAM THOMPSON BRIGGS, M.D.
1885. tMOSES GUNN, A.M., M.D., LL.D.
1886. tHUNTER McGUIRE, M.D., LL.D.
1887. tD. HAYES AGNEW, M.D., LL.D.
1888. DAVID WILLIAMS CHEEVER, M.D., LL.D.
1889. tDAVID W. YANDELL, M.D.
1890. tCLAUDIUS HENRY MASTIN, M.D., LL.D.
1891. PHINEAS SANBORN CONNER, M.D., LL.D.
1892. NICHOLAS SENN, M.D., Ph.D., LL.D.
1893. J. EWING MEARS, A.M., M.D.
1894. FREDERIC SHEPARD DENNIS, M.D.
1895. LOUIS McLANE TIFFANY, A.M. Cantab., M.D.
1896. JOHN COLLINS WARREN, M.D., LL.D. (Jefferson),
Hon. F.R.C.S. Eng.
1897. tTHEODORE F. PREWITT, M.D.
1898. WILLIAM W. KEEN, A.M., M.D., LL.D., Hon. F.R.C.S.
1899. ROBERT F. W^EIR, A.M., M.D., F.R.C.S. Eng.
1900. ROSWELL PARK, M.D.
1901. DE FOREST WILLARD, A.M., M.D., Ph.D.
1902. MAURICE H. RICHARDSON, A.B., M.D.
1903. NATHANIEL P. DANDRIDGE, M.D.
1904. GEORGE BEN JOHNSTON, M.D.
1905. ALBERT VANDER VEER, M.D.
1906. DUDLEY P. ALLEN, M.D.
1907. WILLIAM H. CARMALT, M.D.
This volume of Transactions cohtains the papers read before the
Association at the Meeting held May 7, 8 and 9, 1907.
The Association assumes no responsibility for the statements and
opinions published in this volume.
AMERICAN SURGICAL ASSOCIATION
* Denotes Original Fellows,
t Denotes Senior Fellows.
1890. Abbe, Robert, M.D., 13 West Fiftieth Street, New York,
Surgeon to St. Luke's Hospital. Vice-President ^ 1901.
1894. Allen, Dudley P., A.M., M.D., President, 1907; 11 10 (old
260) Euclid Ave., Cleveland, Ohio. Professor of Surgery,
Medical Department of Western Reserve University; Visiting
Surgeon, Lakeside and Charity Hospitals; Consulting Sur-
geon to the Cleveland City Hospital.
ti89o. Allis, Oscar Huntington, A.M., M.D., 1604 Spruce Street,
Philadelphia. Surgeon to the Presbyterian Hospital.
1902. Andrews, E. WyllysÂ» A.M., M.D., 2525 Prairie Avenue,
Chicago, III. Professor of Surgery, Northwestern University
Medical School; Surgeon to Mercy Hospital and Michael
Reese Hospital; Attending Surgeon to Cook County Hospital;
Consulting Surgeon to the Provident Hospital.
1901. Armstrong, George E., CM., M.D., 320 Mountain Street,
Montreal. Associate Professor of Clinical Surger}% McGill
University; Surgeon to the Montreal General Hospital; Sur-
geon to the Western Hospital, Montreal.
1906. Barrow, David, ^LD., 148 Market Street, Lexington, Ky.
ti882. Barton, James M., A.M., M.D., 220 Railroad Ave., Atlantic
City, N. J.
X FELLOWS OF THE ASSOCIATION
1901. Bell, James, M.D., Vice-President, 873 Dorchester Street,
Montreal. Professor of Clinical Surgen-, McGill University;
Surgeon to the Royal Victoria Hospital.
1900. Bevan, Arthur Dean, M.D., 100 State Street, Chicago. Asso-
ciate Professor of Surger>', Rush Medical College, University
of Chicago; Surgeon to Presbyterian Hospital.
1901. Binnie, J. F., M.B., CM. (Aberdeen), Argyle Bldg., Twelfth and
McGee Sts., Kansas City, Mo. Professor of Surgical Path-
ology and Clinical Surgery, Kansas City Medical College.
1906. Blake, John Bapst, A.M., M.D., 178 Beacon Street, Boston,
Mass. Instructor in Surgery, Harvard Medical School; Assis-
tant Surgeon to the Boston City Hospital; Surgeon to the
Long Island Hospital and St. Elizabeth's Hospital, Boston,
1902. Blake, Joseph A., M.D., 601 Madison Avenue, New York.
Instructor in Surgery, Columbia University; Attending Sur-
geon to St. Luke's Hospital; Junior Surgeon to the Roosevelt
Hospital; Consulting Surgeon to the Northern Dispensary'.
1901. Bloodgood, Joseph C., B.S., M.D., 904 North Charles Street,
Baltimore, Md. Associate in Surgery in the Johns Hopkins
1882. BoNTECor, Reed Brockway, M.D., 82 Fourth Street, Troy,
N. Y. Surgeon to the Marshall Infirmary.
1901. BosHER, Lewis C, M.D., 717 East Franklin Street, Richmond,
Va. Professor of Surger\', Medical College of Virginia; Sur-
geon to the Old Dominion Hospital.
1890. Bradford, Edward Hickling, A.B., M.D., 133 Newbury
Street, Boston. Surgeon to the Children's and the Samaritan
Hospitals; Assistant Professor of Orthopedic Surgery in the
1900. Brewer, George Emerson, M.D., 61 West Forty-eighth Street,
New York City. Professor of Clinical Surgery in College of
Physicians and Surgeons, Columbia University; Junior Sur-
geon, Roosevelt Hospital; Attending Surgeon, City Hospital;
Consulting Surgeon to the Ophthalmic and Aural Institute,
and to the Perth Amboy Hospital.
1906. Bristow, a. T., A.B., M.D., 234 Clinton Street, Brooklyn, New
York. Clinical Professor of Surger}' at the Long Island Col-
lege Hospital ; Attending Surgeon to the Kings County Hospital,
St. John's Hospital, and Long Island College Hospital; Con-
sulting Surgeon to the Long Island State Hospital, the Bush-
wick Central Hospital, and the Swedish Hospital.
FELLOWS OF THE ASSOCIATION XI
1S95. Bryant, Joseph D., M.D., 32 West Forty-eighth Street, New
York. Professor of Anatomy and of Operative and Clinical
Surger>% Bellevue and St. Vincent's Hospitals; Consulting
Surgeon to Gouvemeur Hospital, Hospital for Ruptured and
Crippled, St. Joseph's and Hackensack Hospitals, Asylum
for Insane, New York, etc.
1SS2. Bull, William Tillinghast, A.B., M.D., 35 West Thirty-
fifth Street, New York. Adjunct Professor of the Practice of
Surgery and of Clinical Surger\' in the College of Physicians
and Surgeons, New York; Surgeon to the New York and
St. Luke's HospiUds; Consulting Surgeon to the Hospital
for Ruptured and Crippled, and to the New York Cancer
1900. Bunts, Frank E., M.D., 275 Prospect Street, Cleveland, Ohio.
Professor of Principles of Surgerj- and Clinical Surger)- in
Medical College of Western Reserve University; V^isiting
Surgeon to St. Vincent's Charity Hospital; Consulting Surgeon
to Cleveland City and Lutheran Hospitals.
1S93. BuRRELL, Herbert Leslie, M.D. (Harvard), 22 Newbur\'
Street, Boston, Mass. Assistant Professor of Surgery in
Harvard University; Visiting Surgeon, Boston City Hospital;
Visiting Surgeon to the Children's Hospital; Consulting Sur-
geon, Carney Hospital and the Quincy Hospital. Secretary
1889. Cabot, Arthur Tracy, A.M., M.D., i Marlborough Street,
Boston, Mass. Surgeon to Massachusetts General Hospital.
+1885. Carmalt, William H., A.M., M.D., 87 Elm Street, New Haven,
Conn, Professor of Surgery in Yale University; Surgeon to
the New Haven Hospital. Vice-President, 1895.
1896. Carson, Norman Bruce, M.D., 303 Humboldt Bldg., St. Louis,
Mo. Professor of Clinical Surgery in the St. Louis Medical
College; Surgeon to St. Louis and MuUanphy Hospitals and
to the St. Vincent Insane Asylum, etc. Vice-President, 1903.
ti882. Cheever, David Williams, M.D., LL.D., 557 Boylston Street,
Boston, Mass. Professor of Surger)' (Emeritus) in Harvard
University; Surgeon to Boston City Hospital. President, 1888.
1896. Cole, Charles Knox, A.M., M.D., Helena, Montana. Sur-
geon to St. John'^, St. Peter's, and County Hospitals.
1898. CoLEY, William B., M.D., 5 Park Avenue, New York. At-
tending Surgeon to the General Memorial Hospital; Associate
Surgeon to the Hospital for Ruptured and Crippled, New York.
Xll FELLOWS OF THE ASSOCIATION
*ti88o. Conner, Phineas Sanborn, M.D., LL.D., 215 West Ninth
Street, Cincinnati, Ohio. Professor of Surger}' in the Medical
College of Ohio; Emeritus Professor of Surgery, Dartmouth
Medical College; Surgeon to the Cincinnati and the Good
Samaritan Hospitals. Presidency 1891; Member of Council y
1883, and 1 895-1 900; Treasurer y 1885-91.
1905. Crile, George W., M.D., 275 Prospect Street, Cleveland, Ohio.
Professor of Clinical Surgery, Western Reserve Medical Col-
lege; Visiting Surgeon to St. Alexis' Hospital; Associate Sur-
geon to Lakeside Hospital.
1896. Curtis, Benjamin Farquhar, A.B., M.D., 7 East Forty-first
Street, New York. Professor of the Principles of Surgery and
Clinical Surgery, University and Belle\aie Hospital Medical
College of New York; Attending Surgeon to St. Luke's and
Bellevue Hospitals, and the General Memorial Hospital for
Treatment of Cancer and Allied Diseases; Consulting Surgeon
to New York Orthopedic Hospital and Dispensar)-.
1906. Gushing, Harvey, A.M., M.D., 3 West Franklin Street, Balti-
more, Md. Associate Professor of Surger\', Johns Hopkins
1896. Gushing, Hayward Warren, A.B., M.D., 90 Commonwealth
Avenue, Boston. Mass. Junior Visiting Surgeon, Boston
City Hospital; Assistant Surgeon, Children's Hospital, Boston.
1897. Da Costa, John Chalmers, M.D., 2045 Walnut Street, Phila-
delphia, Pa. Clinical Professor of Surgery, Jefferson Medical
College; Surgeon to the Philadelphia and the Phoenixville
1883. Dandridge, Nathaniel Pendleton, M.D., 422 Broadway,
Cincinnati, Ohio. Professor of Practice of Surger\' and of
Clinical Surgery- in the Miami Medical College, Cincinnati.
President^ 1904. Treasurer, 1894-96. Member 0} CounciL
1892. Deaver, John B., M.D., 1634 Walnut Street, Philadelphia.
Surgeon-in-Chief to the German Hospital, Philadelphia.
1882. Dennis, Frederic Shepard, M.D., F.R.C.S. Eng., 542
Madison Avenue, New Y'ork. Professor of Clinical Surger}-,
Cornell University, New York City; Visiting Surgeon to the
Bellevue and St. Vincent's Hospitals; Consulting Surgeon to
St. Joseph's Hospital, Yonkers, and Montefiore Home, New
York City. President, 1894; V ice-President, 1887; Member
0} Council, 1889.
FELLOWS OF THE ASSOCIATION xiii
1901. Eliot, Ellsworth, Jr., M.D., 48 West Thirty-sixth Street,
New York. Clinical Lecturer and Demonstrator of Surger}',
College of Physicians and Surgeons, New York; Surgeon to
the Presbyterian Hospital.
1893. Elliot, John Wheelock, A.M., M.D. (Harvard), 124 Beacon
Street, Boston. Surgeon to Massachusetts General Hospital.
1S96. EsTES, William Lawrence, A.M., M.D., South Bethlehem,
Pa. Director and Surgeon-in-Chief of St. Luke*s Hospital;
Lecturer on Hygiene at Lehigh University.
1598. Eve, Duncan, A.M., M.D., 700 Church Street, Nashville, Tenn.
Professor of Surgery and Clinical Surger}', Medical Department,
Vanderbilt University; Surgeon to the Nashville City Hospital.
1901. Ferguson, Alex. Hugh, CM., M.D., 10 Drexel Square, Chi-
â€¢ cago, 111. Professor of Clinical Surger>' in the Medical De-
partment of the University of the State of Illinois; Professor
of Surger}' in the Post-Graduate Medical School of Chicago;
Surgeon-in-Chief of the Chicago Hospital; Surgeon to Cook
County Hospital for the Insane; Consulting Surgeon to Provi-
1599. Finney, John M. T., M.D., 1300 Eutaw Place, Baltimore, Md.
Associate Professor of Surgery, Johns Hopkins University.
1904. Frazier, Charles Harrison, M.D., 1724 Spruce Street, Phila-
delphia, Pa. Professor of Clinical Surger\', University of
Pennsylvania; Surgeon to the University Hospital.
1S98. Freeman, Leonard, B.S., M.D., 1801 Franklin Street, Denver,
Col. Professor of Surger>', Gross Medical College; Surgeon
to the Arapahoe County Hospital and to St. Anthony's Hospital.
tiS82. Gay, George Washington, A.M., M.D., 665 Boylston Street,
Boston, Mass. Senior Surgeon to the Boston City Hospital,
Clinical Instructor in Surgery in Harvard University. Member
0} Council, 1882.
1892. Gerrish, Frederic Henry, A.M., M.D. (Bowdoin), LL.D.
(University of Michigan and Bowdoin), 675 Congress Street,
Portland, Maine. Professor of Surger\' in the Medical De-
partment of Bowdoin College; Consulting Surgeon, Maine
1S90. Gerster, Arpad G., M.D., Chir. D., 34 East Seventy-fifth
Street, New York. Professor of Surgery in the New York
Polyclinic; Surgeon to the German and Mount Sinai Hos-
XIV FELLOWS OF THE ASSOCIATION
1906. Gibbon, John H., M.D., 1608 Spruce Street, Philadelphia.
Professor of Surger}% Jefferson Medical College; Surgeon to the
Pennsylvania Hospital and the Br}'n Mawr Hospital ; Consult-
ing Surgeon to the Woman's Hospital.
1906. Gibson, C. L., M.D., 8 East Fifty-eighth Street, New York,
N. Y. Professor of Clinical Surgery, Cornell University
Medical College; Surgeon to St. Luke's and the City Hos-
ti892. Halsted, William Stewart, B.A., M.D., 1201 Eutaw Place,
Baltimore, Md. Surgeon to Johns Hopkins Hospital.
1898. Harrington, Francis B., A.B. (Tufts College), M.D. (Har-
vard College), 201 Beacon Street, Boston, Mass. Surgeon
to Massachusetts General Hospital.
1900. Harris, Malcolm L., M.D., 612 Reliance Building, Chicago,
111. Professor of Surger>% Chicago Polyclinic; Attending
Surgeon, Alexian Brothers* Hospital, St. Luke's Hospital, and
Maurice Porter Hospital for Children.
1895. Harte, Richard H., M.D., Recorder, 1503 Spruce Street,
Philadelphia. Associate Professor of Surgery, University of
Pennsylvania; Surgeon to the Pennsylvania Hospital, and
Orthopedic Hospital and Infirmary jfor Nervous Diseases;
Consulting Surgeon to St. Mar\''s, St. Timothy's, and Brj^n
1898. Hearn, W. Joseph, M.D., 11 20 Walnut Street, Philadelphia.
Clinical Professor of Surger\', Jefferson Medical College;
Visiting Surgeon to the Philadelphia Hospital; Consulting
Surgeon to the Phccnixville General Hospital.
1899. HoRWiTZ, Orville, M.D., 1721 Walnut Street, Philadelphia.
Clinical Professor of Genito-urinary Diseases, Jefferson Med-
ical College; Surgeon to the Philadelphia Hospital; Con-
sulting Surgeon to State Hospital for Insane and Hayes
1901. Huntington, Thomas W., A.B., M.D., Vice-President, 11 18
. Sutter Street, San Francisco, California. Professor of Clinical
and Operative Surgery, Medical Department, University of
California; Visiting Surgeon to the City and County Hospital,
San Francisco; ConsuUing Surgeon, St. Luke's Hospital, San
T901. Jacobson, Nathan, M.D., 430 South Salina Street, Syracuse,
N. Y. Professor of Clinical Surgery, College of Medicine,
Syracuse University; Surgeon to St. Joseph's Hospital.
FELLOWS OF THE ASSOCIATION XV
1901. Johnson, Alexander B., M.D., 12 East Fifty-eighth Street,
New York. Professor of Clinical Surgen-, Cornell University
Medical College; Attending Surgeon to New York Hospital.
1905. Johnson, Robert W., A.B., M.D., loi W. Franklin Street,
Baltimore, Md. Professor of Principles and Practice of
Surgery, Baltimore Medical College; Surgeon to Mar\'land
General Hospital; Church Home and Infirmar\'; St. Agnes*
1896. Johnston, George Ben, M.D., 405 East Grace Street, Rich-
mond, Va. Professor of the Practice of Surger)- and of Clini-
cal Surgery in the Medical College of Virginia; Surgeon to
the Old Dominion Hospital, .and Consulting Surgeon to the
Richmond City Free Dispensar\'. President j 1904; Member