A report on the operations for fissures of the palatine vault / by Thomas D. Mütter.

  • Mütter, Thomas D. (Thomas Dent), 1811-1859.
Date:
1843
Catalogue details

Licence: Public Domain Mark

Credit: A report on the operations for fissures of the palatine vault / by Thomas D. Mütter. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    where room is much wanted, it will be well, whenever the patient is trustworthy, to discard them entirely. Motion of the Tongue.—Another difficulty is the motion of the tongue. As it is impossible to perform the different steps of the operation unless the cleft is readily reached, and as the constant motion of the tongue, uncontrollable in some cases, by an involuntary effort of the patient, effectually pre- vents this, surgeons have contrived a variety of instruments for keeping it out of the way. An oval plate mounted on a handle, so curved as to avoid pressure upon the teeth, has been used by Professor Gibson, and serves a very good pur- pose when such a thing is required. But when the patient has been accustomed by repeated trials to keep the tongue quiet while the mouth is held open this difficulty may be con- siderably diminished. In the three operations upon the palate now reported, it was unnecessary to use any thing to fix the tongue, the patients having been previously prepared for the operations by the efforts already referred to. Breaking of Needles.—When the needles employed are badly tempered it may happen that the pressure of the forceps will cause them to snap. This happened to a distinguished surgeon who recently attempted the operation upon a very unruly patient. The needles in consequence of the frac- ture were swallowed, and some difficulty occurred in their removal from the oesophagus, although this was ultimately accomplished. Hemorrhage.—-Some have expressed much dread of the hemorrhage occasioned by the freshening of the edges of the cleft, and many dwell upon the annoyance expe- rienced during the introduction of the ligatures, from the blood covering the parts and thus preventing, to a certain degree, the proper location of the needles. So far as I have been able to judge from my own cases, and from those of some of my friends, this difficulty is one of minor importance, and the oozing of the blood may be readily checked by cold and astringent gargles. Difficulties after the Operation.—In order that reunion