Varga Benedek szerk.: Orvostörténeti közlemények 149-157. (Budapest, 1996)

ADATTÁR / DOCUMENTS - Balogh János: Appendektómia 1735-ben. Claude Amyand beszámolója az első sikeres vakbélműtétről

VIII. Of an Inguinal Rupture, with a Pin in the Appendix Coeci, incrusted with Stone; and some Observations on Wounds in the Guts; by Claudius Amyand, esq; Serjeant Surgeon to His MAJESTY and ER.S.* October 8, 1735. Hanvil Anderson, a Boy, 11 Years of Age, was admitted into St. George's Hospital near Hyde-Park Corner, for the Cure of a Hernia Scrotalis, which he had had from his Infancy, and a Fistula between the Scrotum and Thigh terminating into it, which for a Month last past had discharged a great Quantity of an unkindly sort of Matter. The Rupture was small, and not troublesome, and Part of it could be replaced, but as it appeared that the Sinous Ulcer sprung from that Part that could not; so 'twas evident that the Cure of the Fistula depended upon the Cure of the Hernia, which latter could be obtained by no other Operation than that for the Bubonocele, which was agreed to, and performed the 6th Day of December following. This Operation proved the most complicated and perplexing I ever met with, many unsuspected Oddities and Events concurring to make it as intricate as it proved laborious and difficult. This Tumour, principally composed of the Omentum, was about the Bigness of a small Pippin: In it was found the Appendix Coeci perforated by a Pin incrusted with Stone towards the Head, the Point of which having perforated that Gut, gave way to a Discharge of Faeces through the fistulous Opening therein, as the Portion of the Pin obturating the Aperture in it shifted its Situation. The Abscess formed in the Hernial Bag occasionally, and the Suppuration for two Months last past from this Place outwardly, had knit and confounded, and, as it were, inbodied together the Gut and Omentum with the Hernial Bag, and these with the Spermatick Vessels and the Testicule, so that it was as difficult to distinguish them from each other, as it was to separate them without wounding them; this Pin, whose Point was fixed in the Omentum, continually shifting its Situation, and occasioning a Discharge of Faeces. The Pin frequently lying in the way of the Knife and starting out of the wounded Gut, as a Shot out of a Gun, the Inundation of Faeces upon this Occasion from a Gut we could not well distinguish, were so many Difficulties in the way: But the greatest yet was, what to do with the Gut, which all this while was unknown, and of which we could not come to the Knowledge, till the Operation was over; for this Appendix Coeci, which was the only Gut found in the Rupture, was so contracted, carnous, duplicated, and changed in its Figure and Substance, that it was impossible to determine what kind of Gut it was, or to find out that it was only this Appendix elongated, and in Disguise. We apprehended none of these Difficulties, when we undertook this Operation, in which we proceeded as usual: The Omentum lying uppermost in the Hernial Bag was dissected from the Parts it was knit to, and particularly the Gut it was imbodied with, and afterwards cut off close to the Abdominal Muscles without any previous Ligature, the Vessels in it being small, and the Substance of it more like a Sweetbread than the Caul. Much Time was spent in this Dissection; we were streightened for Room, and greatly disturbed by the Discharge of the Faeces coming out of the Gut, upon every Motion the Pin Amyand, Claude (megh. 1745-ben) 1716-ban lett a Royal Society tagja. v.o. Creese, P.G. ,,The first appendectomy" Survey Gyn. and Obst. 97 (1953) pp 643—652. Schultheisz E. szíves közlése. Bár a szöveg írásmódján, központozásán és a kiemelésein nem változtattunk, a közérthetőség kedvéért az «5» betűket «s»-re írtuk át. A Szerk.