54 
The International Journal of Surgery. 
IMPUTATION OP THE LEG OF A 
SIOUX INDIAN. 
A 
By Z. T. Daniel, M.D., 
Physician U~nS> Indian Service. 
The following operation is not so interesting per 
se as the circumstances which made it possible to be 
performed. Viewed in the latter light, it has some 
points of interest, and I will therefore attempt a brief 
account of it. On the occasion of the visit of the Sioux 
Commission, consisting of General Crook, Gov. Foster 
and General Warner, to the Cheyenne River Indian 
Agency, So. Dak., for the purpose of treating with 
the Sioux in behalf of the Government, for a cession 
of a part of the Great Sioux Reservation to the 
United States, all the Indians of the Agency were 
summoned to be present at the “Great Council,” 
and participate in its proceedings, as well as to 
attach their signatures to the agreement. 
The Indians, numbering some three thousand 
souls, were encamped around or near the agency, 
and when not busy in my office, I was going through 
their camps looking for cases. In one tepee I found 
a sad, emaciated, wan-looking young Indian, whose 
anxious expression and debilitated condition attracted 
my attention ; on asking him his name (in Sioux) 
he replied it was Cecct Yamni, the translation of 
which is “Three Thighs.” I observed that one of 
his feet was wrapped in a dirty cotton cloth, stiff 
from dessicated pus, and emitting a dreadful odor. 
I asked him to show me his foot, as I knew that the 
trouble was located there. He slowly removed the 
cloth, and exposed a greatly swollen left foot and 
ankle. I took a pocket case probe and inserted it 
into five large sinuses, and at the bottom of each I 
detected dead bone. The sinuses were located on 
each side of the foot opposite the bones of the tarsus. 
A diagnosis of necrosis of the tarsus was made. 
Owing to the absence of hospital facilities, an 
operation for removal of the necrosed bones was 
only to be considered. He said he had not walked 
for three years, and had made up his mind to die. 
With no idea that he would ever consent, I said : 
“ There is no use of your dying, as I can take off 
that foot, and you will live out your days.” “No,” 
said he, “I would rather die than be cut like that.” 
I explained to him the feasibility of the operation, 
its daily occurrence among the whites, etc., but all 
to no purpose. 
Some days subsequently I met a gentleman from 
Pierre, President of the Board of Trade, who had 
visited the Agency to see how the Commission was 
progressing in its work of opening up the Reser- 
vation, as that city was vitally interested in the 
success of the enterprise. I noticed that this gen-, 
tleman walked with a cane and had a very perceptible 
limp in his gait, and questioned him as to the cause 
mf his lameness. He said that he wore “an artificial 
mg, having had his limb amputated in its lower third 
kfcnSkdiseased foot some years ago.” From the ease 
Ibd agility with which he moved, no one would have 
supposed him minus a foot, and it occurred to me to 
take this gentleman out to Three Thigh’s tepee and 
give him an ocular demonstration of the results of 
an amputation of the foot. The gentleman con- 
sented, and we went forthwith. I had him walk, 
run and jump in the tepee, and then asked Three 
Thighs if he saw anything wrong about that man’s 
movements ? He said “Ho, he gets about all right.” 
“ Well,” said I, “his leg has been taken off exactly 
where I proposed to remove yours ; after the ampu- 
tation you will be just as well off as he.” Knowing 
the Sioux to be expert horsemen, I added that he 
would also be able to ride horseback, to plough, cut 
hay and climb ladders. I requested the gentleman 
to show my patient his stump and the mechanism of 
the artificial apparatus ; he did so, and if I live one 
hundred years, I do not expect to see a more thor- 
oughly astonished human being, than was that poor 
ignorant savage. After he had fully taken in the 
situation he said, “ you may do it.” 
His tepee was placed near my residence at the 
Agency, and I at once began a preparatory treatment. 
His foot and ankle joint were in the condition 
represented by the illustration below. 
Fig. 1. 
REPORT TO THE INDIAN BUREAU AT WASHINGTON, 
SEPTEMBER, 1889. 
“ He was a full-blooded Santee Sioux, 22 years old, 
unmarried, of scrofulous constitution, suffering from 
necrosis of the left tarsus. I amputated by the 
circular method at junction of middle and lower The Ihternatiohal Journal of Surgery. 
55 
thirds of leg, Sept. 18, 1889, at 12 M„ assisted by 
Dr. J. B Ferguson, A. S., U„ S. A.; Chas. E. 
McChesney, U. S. Indian Agent ; W. G. Waters, 
Supt. Indian School, and Mr. Shoemaker, Hospital 
Steward, U. S. A. The disease for which the am- 
putation was advised and performed, is one of com- 
mon occurrence among the Sioux, and, in nearly 
every instance, destroys the victim. In this case it 
was of three years’ duration, and had greatly im- 
paired the sufferer’s general health ; he was confined 
to his tepee and unable to walk or even assume the 
upright posture with the aid of crutches, as the 
foot was so swollen and painful that even slight 
pressure, caused the most exquisite pain. He moved 
about on his hands and knees, and only to obey the 
calls of nature. He was practically helpless, morose, 
sad, gloomy and most of the time in tears. I 
explained to him that the only chance of saving his 
life, was to remove the dead foot; and, after a 
brief hesitation, and witnessing a gentleman from 
Pierre walk around with an artificial leg of exactly 
the same character as he would have, he consented 
to the operation. I then placed him upon a prepara- 
tory treatment for some weeks, superintending his 
food, etc., etc., and on Sept. 16, took him into my 
private house, where the operation was performed as 
stated above. On Sept. 22, I observed he was lone- 
some from the lack of associates of his race, and at 
his request, removed him to his sister’s quarters at 
the Agency. I have been his sole nurse and atten- 
dant, supervising his diet and sanitation, and dress- 
ing his limb whenever required. At this writing, 
October 4, he is in fine spirits, free from all pain, 
and the wound is doing nicely. I could not ex- 
pect his condition to be better. This is the first 
amputation at this Agency, and there is every indi- 
cation that it will be a complete success.” 
placed in bed with the stump elevated on a pillow. 
Considerable pain was felt for three or four days, 
but was easily controlled by morphia. The wound 
healed by granulation, without occurrence of secon- 
dary hemorrhage. When the stump had assumed the 
appearance presented in the preceding illustration, I 
made measurements as directed by the firm of A. A. 
Marks, New York, taking great care to have them 
precise, and forwarded the same to them, with au- 
thority from General J. F. Morgan, Hon. Commis- 
sioner Indian Affairs, to make a Teg for the patient. 
It arrived promptly and was applied. Three Thighs 
walked off with it, a happy Indian, and goes about, 
any and everywhere, on foot or horseback, with the 
greatest ease. The operation and its results is a 
Fig. 3. 
great wonder to these people, many of whom said 
that he would certainly die if the “ White Medicine 
Man should cut him.” Incidents like this, do much 
toward civilizing the Indian, because they are ocular 
demonstrations of the superiority of the white man’s 
skill, over that of their native medicine man. 
Surgery among Indians should never be attempted 
unless the operator is almost certain of success, for 
one failure, ending in death, will never be forgotten 
nor understood by them. After Three Thighs had 
worn his leg some days, he desired a photograph of 
himself, and the accompanying illustration shows 
him in full Sioux costume, with his leg in situ. 
Fig. 2. 
During the operation the arteries were secured by 
silk sutures which were left in the stump. The flap 
was adjusted by interrupted silk sutures, a roller 
bandage applied over the end of stump, surmounted 
by antiseptic gauze and cotton batting ; the patient