On the results of thyrotomy for the removal of growths from the larynx ... / by Morell Mackenzie.

  • Morell Mackenzie
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: On the results of thyrotomy for the removal of growths from the larynx ... / by Morell Mackenzie. Source: Wellcome Collection.

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    lungs. But after artificial respiration had been carried on for several minutes the little patient recovered. Mr. Durham even tries to qualify the only deaths he has at all ad- mitted in the following words : In each of these [cases] the fatal result was brought about in a manner by no means special to the operation, but, alas! of far too common occurrence in general surgical experience. Upon this I have only to remark that when blood-poisoning ceases to follow operations, no doubt many surgical procedures will be adopted which are not at present in vogue; but that until that time arrives, sep- ticaemia remains one of the contingent risks of all operations. On the other hand, the life of the patient is not imperilled by this danger when laryngoscopic treatment is adopted. ' In referring to my observations on the mortality of thyrotomy, Mr. Durham has produced a very erroneous impression as regards my treat- ment of the subject. He has made it appear as if, whilst comparing the mortality of laryngoscopic treatment with that of thyrotomy, I have concealed the circumstance that the laryngoscopic cases in my essay were aU benign, and that the thyrotomy table included some cases of cancer.- By inference he leads his readers to suppose that I have made an unfair comparison between the two sets of cases. Mr. Durham remarks as follows:—Considering the prospect of the ope- ration in relation to the preservation of life. Dr. Mackenzie says, in division of the laryngeal cartilages, there is always some immediate danger to Hfe, and nine out of the twenty-eight cases on record termi- nated fatally. If Mr. Durham wished to do justice to my views, it is strange that he quoted an isolated passage, and did not add the remarks on the same page (94) viz., In six of the nine fatal cases in the thyro- tomy table the disease was cancerous (or semi-malignant). So far from attempting to conceal the inclusion of malignant cases, I called special attention to their admission, not only in the passage referred to, but also in almost the same words when speaking of recur- rence, where I not only gave prominence to the inclusion,of cancer cases, but pointed to the pathological character of the growths as a cause of their great disposition to recurrence.* I also called attention to the inclusion of cancer cases at the head and foot of my thyrotomy table. It is certainly remarkable that Mr. Durham, who objects to my The following is the expression used by me :—In six other cases, the patient died at the end of a few months ; and in nearly all of these, recurrence had taken place. They were all, however, of maliRnant or semi malignant character and therefore the tendency to reproduction was no doubt very great.—O/. cit, p 97