Injuries and diseases of the jaws : the Jacksonian prize essay of the Royal College of Surgeons of England, 1867 / by Christopher Heath.

  • Christopher Heath
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Injuries and diseases of the jaws : the Jacksonian prize essay of the Royal College of Surgeons of England, 1867 / by Christopher Heath. 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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    restrained Ly the actual cautery, and the cavity of the wound was stuffed with strips of lint soaked in a strong solution of chloride of zinc. The growth appeared to have commenced in the antrum, the w^alls of the latter l)eing partially absorbed, the anterior almost wholly, thereby allowing invasion of the orbit, the mouth, and the pharynx. Several pieces of dead bone, surrounded by offensive pus and debris of broken-down growth, were found in its cavity, thus accounting for the inflammatory condition of the superjacent skin, and the purulent discharge from the mouth and nostrils. In other parts the growth was of a yellowish colour, translucent, gelatinous, and vascular. Several ordinary soft gelatinous polypi were extracted from the right nostril during the ojDeration. In sections taken from the margin of the growth near the gum, the microscope showed cylinders of epithelium cells, irregular in form and sinuous in outline, sometimes anas- tomosing, set in a stroma made up of fibrous tissue and spindle-shaped cells. Epithelium nests were observed here and there, but these were few, small, and ill-developed. The papillai of the mucous membrane covering the gum, where the latter was infiltrated, were hypertrophied. The histological characters of the growth appeared to correspond with those of the epitheliome tubule of Cornil and Eanvier. On June ] 3 pneumonia was present at the base of the right lung, and on the following day friction sounds were audiljle over the affected area. The edges of the skin wound had united, except at the inner angle of the orbit. On the 16th there were dulness, extremely weak breath sounds, diminished vocal fremitus, and resonance to the angle of the right scapula, with bronchial respiration above. Tlie lymphatic glands, which had become larger and very tender in the riglit posterior triangle, had diminished in size after treatment with belladonna and poulticing. On the 18th the physical signs of pneumonia at the left base became evident, and the general condition of the patient worse, though he wanted to be up and about. The foetor from the cavity of the wound w'as now almost intolerable, and one or two sloughs had separated. From this time the chest symptoms increased in severity, and he died on June 26. Necropsy (by Mr. Barker) twenty-Jive hours after death.—