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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    who took up the vessels of the flap. Eeturning to the middle line, Mr. Heath made a second incision on the left side of the fungus, meeting the former one above and below, and dissected back the skin off the tumour, as far as the jaw. The bone being isolated with the assistance of Mr. Erichsen, the second molar tooth was drawn, and a narrow saw applied at that point; but before complete division was effected the weight of the tumour caused it to break away. As had been pre-arranged, Sir H. Thompson then grasped the tongue, which was now seen for the first time, and transfixed the tip with a stout needle and ligature, by which it wa.s held until the operation was concluded. On dividing the mucous mem- brane beneath the tongue, a large lobulated mass came into view imbedded among the sublingual muscles; and this being dragged forward, the muscles were divided close to the tumour, and one or two bleeding vessels were promptly secured by Mr. B. Hill. The tumour being then turned over to the right side, Mr. Heath carried the knife upwards, so as to clear the coronoid process, which was healthy; but this appeared to be driven forward against the malar l^one, and tightly jammed, so that forcible traction made on the tumour failed to clear it. Grasping the process itself with the lion forceps, Mr. Heath succeeded, however, in wrenching it out, when the condyle of the jaw, also healthy, immediately came forward without any dissection. A little dissection round the posterior margin of the tumour now completely disconnected it, and it was removed. About half a dozen bleeding vessels were now tied, none of them of large size, the two facial arteries having been preserved uncut. Finding the bone on the left side where the tumour had broken away rough and irregular, Mr. Heath sawed it cleanly through, close in front of the wisdom tooth. There was now an enormous gap ; the fauces, tongue, and front of the larynx being fully exposed, and the flap of skin on each side being pendulous and superabundant. The right was somewhat ragged, owing to the perforation which liad taken place, and also owing to its being so adherent to the tumour that it had been perforated at one or two points; Mr. Heath therefore removed a ]>ortion of it, adapting the opposite flap to it. The lip was then l)rought together with three hare-lip pins and a twisted suture, and the remainder of the incision was held together with four silver sutures, placed some distance apart so as to allow discharge to escape. The thread holding the tongue was next secured to the hare-