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An interesting account of probably the first
supra-pubic lithotomy was given by Dr. Rudolph
Menger of San Antonio, in Daniel's Texas Medical
Journal in 1886. It is of sufficient importance in
the development of surgery in Texas to quote:
"April 27th, an interesting case of supra-pubic
lithotomy was performed here by Dr. A. Hahn, as-
sisted by Drs. P. W. Johns, J. Favre, and myself,
the result of which I take the liberty to report, in
short as follows:
Patient (male) about 36 years, complained, as
I understand for many weeks, and more so two
years ago, from symptoms of stone in the bladder,
enlarged prostrate, cystitis and partial retention of
urine. On introducing the catheter and examining
per rectum the prostate proved to be hypertrophied
and the stone lodging behind the gland, somewhat
to the right and upwards of the collum vesicae.
The evacuated urine contained large blocks of
mucus and pus-highly albuminous urine. After
washing the bladder out thoroughly with antiseptic
warm water, and introduction of a rubber bag into
the rectum, filled with water, and filling the bladder
with antiseptic fluid-the incision (about two
inches) was made in the linea alba, dividing care-
fully and under scrupulus cleanliness the deeper
tissues, and ligating every small vessel with catgut
that came under the knife before reaching the fascia
and bladder. On account of the rather small, and,
as it seemed, retracted bladder and hypertrophied
gland, and the situation of the stone, which was
firmly impacked in the mucous membrane, it was
with much difficulty to reach and feel the end of the
catheter. The bladder was secured with several
catgut ligatures and opened without reaching the
peritoneum. There was but very little bleeding,
considering that the subject was a very unfavorable
one for anesthetizing, ether being used at first, and
afterwards, chloroform. The stone was a large
(mulberry) one, of oval shape, and as already
mentioned, firmly incrustated in the bladder. The
operation itself took about two and one-half hours,
but, on account of the difficulty in bringing the man
under anesthetics, the entire operation took five
hours time. The patient is doing well up to date
of writing, two days after operation.
Now the above case is reported mainly on ac-
count of its interesting features, and especially be-
cause the supra-pubic mode of operating is rarely
made in America, and perhaps never before in
Texas. In Cupple's admirable compilation of sta-
tistics of "Texas Surgery," no such operation is
recorded, as will be seen from the report of all
cases recorded."
Still of considerable interest is the case re-
ported in the Texas State Medical Journal of 1875,
describing a successful transplanting of skin by
Dr. C. W. Trueheart of Galveston, in 1872. The
method consisted of grafting of skin by pedical
flap from the side to the hand, and the successful
grafting from the mother and aunt to the wound
on the side from which the graft was taken. Dr.
Trueheart served in the German Army throughout
the Prussian War, and it is reported that he brought
from Germany the first fever thermometer to be
used in this country.
There was published in 1886 a Report of the
Committee on Surgery of the Texas State Medical
Association, which is remarkable in its complete-
ness and the amount of work expended upon it
during those early days. Reference is often made
to an earlier report of this committee which was
made in 1878, and summarizes the operations which
had been done in Texas up to this time. This re-
port states that eighteen hundred and seventy-five
operations were reported, but I have been unable
to find a publication of this report. The Committee
who made this report consisted of E. J. Beall, J. M.
Pace, A. G. Clopton, B. F. Eads, D. F. Stuart and
George Cupples. The Chairman of this Committee
was Dr. George Cupples who apparently was a re-
markable man and largely responsible for this
report. (Dr. E. J. Beall, a distinguished and learned
surgeon was the father of our highly esteemed
Fellow, (Dr. Frank Beall.) This report was well
received which can be seen by the following ex-
tracts from Texas Medical Journal of 1886:
"The Committee (Dr. Cupples, Chairman) have
received letters of warm commendation from the
most distinguished medical men of Europe and
America. Amongst the lights who have compli-
mented the work, we may be pardoned for mention-
ing Bowditch, Gregory, Lawson Tait, S. W. Gross,
Senn, Battey, Richardson, Barker, Bodenhamer,
Pepper, Ashhurst, Packard, Sinclair, T. G. Thomas,
W. L. Lee and others. This great compliment-the
endorsement of the whole profession of America
and part of Europe, should stir the pride, and
stimulate the zeal of our surgeons, and induce them
to contribute more freely and fully, their cases.
The work will be continued and though the med-
ical history of the past may never be written, a
mistaken notion of propriety may prevent many of
the now pioneers of Texas medicine from giving
their biography to the world, this, we repeat, will
be a monument to their worth and ability, the one
stone left to tell that they once lived and labored.
Under the head of 'Texas Surgery,' we may mention
that every day creditable operations are being per-