The Boston Medical and Surgical Journal (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1878. Excerpt: ... passed into the throat, the tumor of the tonsil was pushed out towards the external wound, so that it was seen bulging and covered by the superior constrictor muscle of the pharynx only. A crucial incision, about one inch long each way, was made through the superior constrictor. The tumor now came in sight plainly. With the director, and with one finger outside and one inside the throat, the diseased mass was separated and removed without serious haemorrhage. The palatoglossus muscle was divided where it adhered to the front of the growth. The palato-pharyngeus was untouched. No artery larger than the facial was divided. The subsequent perfect use of the parts proved that the hypoglossal, gustatory, and glosso-pharyngeal nerves were intact. After removing the tonsil a large hole opened directly into the throat, beneath and below the jaw, and between the pillars of the fauces. The sawn edges of the jaw were drilled and brought together with one wire, and silk sutures were taken in the upper part of the vertical cut of the skin, and in the cross-cut, the original incision being left open. A wet compress and bandage were applied. At no time was haemorrhage excessive. Fourteen ligatures were used. The ends of these, with the ends of the wire, were left protruding through the wound. Brandy one ounce, and beef essence four ounces, by the rectum, were ordered every four hours during the night; forty minims of liq. opii comp. being added at 7.30 p. M. January 5th. Twenty-four hours after the operation the trachea tube was removed. Patient doing remarkably well. Has retained all injections but the first. No shock. Pulse good. Some slight oozing from the external wound. Patient drinks milk by single swallows, none of it passing through the wound, though the edges ...