A manual of the injuries and surgical diseases of the face, mouth, and jaws.

  • Marshall, John Sayre, 1846-1922.
Date:
1902
Catalogue details

Licence: Public Domain Mark

Credit: A manual of the injuries and surgical diseases of the face, mouth, and jaws. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    ing antisyphilitic treatment, and at the same time inoculating several guinea-pigs or rabbits, after the method of Koch, by implanting sub- cutaneously small fragments from the diseased area, as these animals are very susceptible to tuberculosis. The doubt is removed either by the improvement manifest in the ulceration, after two or three weeks, as a result of the antisyphilitic treatment, or by the production of tuberculosis in the inoculated ani- mals, and their death at the end of five or six weeks. If the fragments which have been implanted are from syphilitic ulcers, it will have no efifect upon these animals, as they cannot be inoculated with syphilis. In differentiating between tuberculosis and epithelioma, the micro- scope is the only reliable means of diagnosis. A section of a tubercular nodule shows a fine, delicate reticulum, the meshes of which are occu- pied by granulation-cells; in epithelioma there is a well-marked retic- ulum, the areolar spaces of which are filled with embryonal epithelial cells, arranged concentrically. Blood-vessels are also abundant in epithelioma, and absent in the tubercle nodule. Glandular infection is an early manifestation in epithelioma, while in tubercular ulcerations of the mucous membrane it is a late manifes- tation or may not occur at all. Simple ulcers of the cheek and tongue sometimes occur from the mechanical irritation of a sharp or jagged tooth, resulting from a cari- ous cavity, or from masses of salivary calculus, or from a misplaced tooth. Such ulcerations are easily recognized from their location and appearance, and only a careless observer would be misled. It should be borne in mind, however, that they may become the focus of infec- tion of tuberculosis, or the starting-point of a carcinomatous growth. Prognosis.—Although lupus is usually confined to the skin, it may attack deeper parts, involving the muscles and periosteum, caus- ing necrosis of the bone. Primary tuberculosis of the skin may lead to infection of the lymphatic glands nearest to the seat of the disease, and eventually to general miliary tuberculosis. Pulmonary tuberculosis often develops as a secondary complication. It occasionally happens that a lupus patch is the cause which locates the formation of a carci- noma. The tendency to local extension varies greatly. In some cases the disease may begin in early life, remain stationary for a number of years, then suddenly become very active and not confined to the skin, but attacking the deeper tissues and destroying them with the greatest rapidity, regardless of their structure. In tuberculosis of the face, the tendency is toward rapid extension; in some cases the soft tissues and the superficial bones may be completely destroyed in a few months. On the other hand, the process of repair by cicatrization follows closely upon the destruction of tissue, and extensive scars are formed, causing frightful deformitv-