Removal of the entire lower jaw.

  • James Rushmore Wood
Date:
[1857?]
Catalogue details

Licence: Public Domain Mark

Credit: Removal of the entire lower jaw. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    in successive portions. This stage is attended with great suffering and constitutional disturbance ; and hot unfrequently patients die from exhaustion during this process of suppura- tion, or from gangrene of the soft parts. If the disease pass on unarrested, the jaw becomes more and more involved, large portions exfoliate, and the whole finally becomes im- plicated. Few survive to this period, and a still less number witness the completion of the morbid process, in the dis- charge of the entire jaw. Mr. Stanley exhibited a patient of St. Bartholomew’s Hospital, suffering from this disease, whose entire lower jaw had exfoliated, excepting one condyle. The prognosis in these cases is very unfavorable. When the disease first comes under notice, the periosteal inflamma- tion has generally long existed, and new formations already separate the bone from its covering. More frequently the suppuration is established, exfoliations of bone are taking place, and the whole morbid process is in active progress. The system now breaks down under the exhausting dis- charges and poisonous emanations from the jaw; and the miserable subject of this destructive disease, falls a victim to its inroads upon his strength, long before the completion of the process of exfoliation. The regeneration of bone, in cases where extensive necro- sis of the jaw occurs, or where it is entirely removed, as in the present instance is an interesting and practical question. From the investigations of Yon Bibra and Geist, we learn that the new deposit derives its nutrition from the periosteum only, and is, therefore, the product of this membrane. Un- like callus, it has no communication of the Haversian canals with the bone upon which it lies, while its medullary canals are vertical to those of the bone. They conclude that the new formation has a lower degree of development than true bone. The following is the average of several analyses of bone and the deposit, made by these authors; and, consider- ing the authority of Von Bibra in the chemical examina- tion of bone, they are worthy of note:—