On the claims of priority in the exsection and disarticulation of the lower jaw : with an appendix containing the report of several operations performed / by Geo. C. Blackman.

  • Blackman, George Curtis, 1819-1871.
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: On the claims of priority in the exsection and disarticulation of the lower jaw : with an appendix containing the report of several operations performed / by Geo. C. Blackman. Source: Wellcome Collection.

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    had become much worse, for he was now strongly threatened with suffocation from the quantity of matter which ran down his throat, whenever he attempted to sleep. This, together with the cough which was excited by the same cause, rapidly exhausted his strength, and gave a serious aspect to his case. Supposing the disease to be limited to the points above specified, my first in¬ cision was made through the enormously swollen cheek, from the angle of the jaw, in a horizontal line, to a point about three-quar¬ ters of an inch below the commissure of the lip. The knife was passed directly down to the bone, and the latter cleared as rapid¬ ly as possible from the soft parts by which it was surrounded. The hemorrhage from the facial vessels was small, and no ligature was necessary. On reaching the inner angle of the jaw, we found a large pouch of most offensive matter, which had burrowed be¬ tween the pterygoid muscles and the bone, and which so en¬ croached upon the pharynx as to add to the danger of the im¬ pending suffocation. This was scooped out, and our exploration continued along the inner side of the ramus, which was found to be in such a ragged condition, as to leave no doubt in the minds of all present as to the propriety of its removal. Another in¬ cision was, therefore, made from the zygomatic process along the posterior margin of the ramus, till it met the outer border of that which had been made along the base of the jaw. Considerable difficulty was experienced in our attempts to disarticulate the bone, as the condyloid process was immovably bound to the glenoid cavity by a deposit of bone. This was finally ruptured, and the operation completed. The only hemorrhage with which we had to contend in the latter part of our proceedings was oc¬ casioned by a plunge of the patient, which nearly upset me, and caused me to divide, either the main trunk or one of the largest branches of the internal maxillary artery. Owing to the retrac¬ tion of the vessel, it was found impossible to apply a ligature; but the bleeding was easily restrained by pressing a piece of sponge into the wound. On account of the absolute impossibility of ascertaining the boundaries of the disease before we com- menced, the operation was necessarily protracted, and, we need not add, severe. Our patient was, of course, greatly prostrated ; not, however, by hemorrhage, for that was but trifling,—but from the shock which so formidable a proceeding must almost invaria¬ bly produce. For some months after the operation he continued to improve in strength. The symptoms of impending suffocation,