Ligature of both carotid arteries for a remarkable erectile tumour of the mouth, face and neck / by J. Mason Warren.

  • Jonathan Mason Warren
Date:
[1846]
Catalogue details

Licence: Public Domain Mark

Credit: Ligature of both carotid arteries for a remarkable erectile tumour of the mouth, face and neck / by J. Mason Warren. Source: Wellcome Collection.

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    6th. Although all pulsations are at an end, the tumour still exists but in a diminished state. Dr. Warren thought that, if left to itself, it would in all probability disappear without further applications; but, as the patient lived at a great distance, it seemed to he a duty to see that the tumour was certainly and perfectly eradicated before he went home to Nova Scotia. The best mode of accomplishing this would be by the application of caus¬ tic, which, perhaps, might be resorted to now that the great vessels were cut off, without danger of hemorrhage. This day, therefore, the use of caustic was commenced by the application of caustic potash, in a solid form, to the wound left by the separation of one of the needles. This wound was about one inch long and two lines wide. A little blood followed the application, which might have arisen from the pressure of the caustic, and therefore a portion of the same substance, in amount eight grains, was applied in powder. 16^^. The caustic has been applied three or four times. Twice a slight hemorrhage has occurred, requiring an intermission in its use. A pulsatory movement having reappeared in the relics of the tumour, the application of ice two or three times a day was directed, to be continued as long as the patient could bear it. To-day the caustic was reapplied to the ulcerated surface, which is about an inch long and half an inch wide. The tumour is sensibly diminishing in size. It will be unnecessary to proceed with all the subsequent details of this case. It is sufficient to state that the different portions of the diseased mass which remained were successively attacked with caustic potash, and with the occasional application of croton oil. Any small arteries, which were discovered running into the tumour, were treated, as in the com¬ mencement of the case, by the needles. On April 5th an operation was performed to excise a portion of the erectile tissue, which existed at the upper part of the wound, when a large vessel was opened and required a ligature. May 20th.—^After the wound from the incision and caustic was nearly healed, a fullness was perceived at its lower angle, immediately above the supra-orbitar foramen. A triangular piece of the suspicious part was there¬ fore cut out and the supra-orbitar artery tied. The whole wound after this last operation was nearly the size of a dollar. Strips of adhesive plaster were applied to approximate its edges. The wmund came together with great rapidity. In a fortnight after the last incision it was healed with a lunated cicatrix, and the parts appeared perfectly sound. The patient is in excellent health, and on this day. May 20th, was discharged to return home, promising to visit us occasionally when he came to Boston. Remarks.—In considering this case the first circumstance which pre¬ sents itself is its protracted and complicated treatment. The necessity of this arose from the obstinate character of the affection. The applications first made were insufficient, and additional remedies were required under
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