RT Journal T1 REports from hospitals. JF Journal of the American Medical Association JO Journal of the American Medical Association YR 1889 FD June 15 VO XII IS 24 SP 838 OP 840 DO 10.1001/jama.1889.02401010010002 UL http://dx.doi.org/10.1001/jama.1889.02401010010002 AB SURGICAL CLINICS AT THE WESTERN PENNSYLVANIA HOSPITAL BEFORE THE STUDENTS OF THE WESTERN PENNSYLVANIA MEDICAL COLLEGE.  BY PROFESSOR J. B. MURDOCH, SURGEON TO THE WESTERN PENNSYLVANIA HOSPITAL AND PROFESSOR OF CLINICAL SURGERY IN THE WESTERN PENNSYLVANIA MEDICAL COLLEGE.[Reported by Will. N. Pringle, M.D., a member of the Graduating Class.January 12, 1889.AMPUTATION OF THE FORE-ARM.We have a patient here this morning who has had his hand traversed by a car-wheel. This happened about two hours ago, and illustrates, very forcibly, the condition in which you will find a limb after an accident of this kind. You will frequently hear people say when they see a contused limb that, "it was merely grazed by the flange." Now this is an impossibility. I think that all of you know that the flange of a wheel is on the inner surface of the wheel, and travels along the inner edge