A dictionary of practical surgery: comprehending all the most interesting improvements, from the earliest times down to the present period : an account of the instruments, remedies and applications employed in surgery : the etymology and signification of the principal terms : ... forming together a "catalogue raisonné" of surgical literature (Volume 2).

  • Cooper, Samuel, 1780-1848.
Date:
1823
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of practical surgery: comprehending all the most interesting improvements, from the earliest times down to the present period : an account of the instruments, remedies and applications employed in surgery : the etymology and signification of the principal terms : ... forming together a "catalogue raisonné" of surgical literature (Volume 2). 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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    nDIX. u some time before had been extracted. That it continued to in- crease gradually ; but being at that time pregnant with her second child, and feeling little pain in the swelling, she took no particular notice of it. Since her delivery, however, which took place about six months before she came to the city, it has increased much more rapidly, but the pain remained as at first, and has been only felt occasionally to shoot through the part. This disease was much less extensive than that in the preceding case, but it reached from the base of the coronoid process to the first bicuspis tooth, ex- tending on each side of the bone to near the base, and as far back as the angle, at which part the base was comprehended lie disease. Several of the teeth had been thrust out by the growth of the tu- mour, and those which remained were very much displaced. The tumour had the same appearance and elastic feel of that in the former case. On the 30th March, at 12 o'clock, Dr. Mott, assisted by Drs. Post, Burrowe, and myself, tied the left carotid artery through an opening of about two inches in length opposite the thyroid cartilage : and so lit- tle was the constitutional effect of this, that it was determined to proceed with the rest of the operation immediately. An incision through the integuments was now made, as in the former ease, he- ginning over the condyloid process above the meatus auditorius, and carried in a semicircular direction below the base of the jaw, to terminate upon the. chin a lit- tle under the lip. The flap of the cheek being dissected up, the first bicuspis tooth was extracted to prepare the way for the saw ; which instrument was then applied, and the bone divided in a perpendicular direction from that situa- tion. The masseter muscle was separa- ted from the angle of the jaw, and the parotid gland carefully elevated anteri- orly, in order to exhibit the bone a little above the angle, that room might be made for the saw The bone was now cut through midway between the processes and angle, it; a line parallel with the zygo- matic arch. The bone was now raised at the chin by the finger .md thumb, then detached from the parts within the mouth by a scalpel, until the diseased mass was com- pletely removed. _ During the elevation f the flap, and removal of the bone, the h mmrhage was profuse. At least a dozen hgatures were applied to bleeding arter.es; some of the vessels bleeding equally nee from both their extremities. The patient bore the operation with undaunted firmness, the flaps of .ntegu- mrnt were brought together by several interrupted sutures, accompanied by ad- hesive straps and proper bandaging. The operation occupied one hour and fifty minutes. 7 o'clock. P. M.— Pulse 88 ; nodded that she was comfortable ; had slept 1 f» minutes, and was refreshed, but was sick at stomach, and had made an effort to vomit ; ordered not to attempt to speak. 10 P M.—Had coughed -some, which was followed by a discharge of fresh blood from the mouth, as well as from the wound, so as to come through the bandage, and run upon the neck. Pulse 88: had taken a little cold water by tea- spoonsful 31s/, 10 A. M.—Had a good night, but coughed hard several times, yet no more bleeding ; felt much refreshed from sleep ; pulse 92; skin natural; took 10 drops tmct. opii to allay cough, but nausea be- ing the effect, was not repeated: to have cold barley water instead of common wa- ter, by the tea-spoonful. JJpril 1st.—Passed an uncomfortable night, owing to cough ; pulse <ju ; was ordered enema communis, which was re- peated in the afternoon with good effect. Five P.M. pulse 120 to 135; articulates a little, though indistinctly ; was ordered a cough mixture. 2d—More comfortable; pulse 88 ; all symptoms favourable. No tumefaction about the eyelids ; cough less. Sd— Felt refreshed ; countenance good; no tumefaction of the face; articulated distinctly; pulse 88 ; complained of hun- ger. 8 P. M. pulse 80; cough was trou- blesome forepart of the day. mixt. ex- pect, cont. 4th.—Said with a distinct and audible voice that shr- was better than at any- other time since thp operation ; felt no pain in the wound ; coughed less ; but from the state of the bandages, the wound was cleaned and dressed. The parts were found to look well; pulse 92; felt hungry ; was ordered some, thin broth. 5^.—Had a comfortable, night; tool, some chicken tea witli much relish ; pulse 104: no appearance of tumefaction. Had an enema this morning which operated well ; cough much relieved. 0//. —Dressed; removed from the upj per wound the sutures, and all the liga- tures except one; parts looked well. The lower wound looked well; but there was little union there by adhesion, proba- bly owing to cough ; pulse 80. ■jth.— [-[as been sitting up in bed a lit- tle ; pulse 32; was ordered sulphate of soda in divided doses. 8tk.—Improving daily; wounds doing well; the last ligature from the upper wound was removed; pulse 120. The increase of pulse probably owing to the operation of salts, which had just then taken place