The surgery of oral diseases and malformations : their diagnosis and treatment / by George Van Ingen Brown.

  • Brown, George van Ingen, 1861-1948.
Date:
1912
Catalogue details

Licence: In copyright

Credit: The surgery of oral diseases and malformations : their diagnosis and treatment / by George Van Ingen Brown. Source: Wellcome Collection.

    36/792 (page 32)
    to every grave surgical operation, and is imperative whenever indications point to unfavoral>le i)lood conditions. Sometimes these cannot be satisfactorily overcome, and the necessity of immediate operation is so urgent as to preclude corrective attempts. When permissible, tonics, good hygiene, and nourishing food may be greatly beneficial. Tendency to hemorrhage may also be reduced by the administration of calcium lactate, or adrenalin or suprarenal extract, for several days before operation. All the.se have been employed with more or less satisfactory results. The possibility of hemophilia should be recognized by a careful .study of family history and records; and questions should be asked to determine whether other members of the family have been bleeders. Swelling of the joints is almost constantly present in these indi- viduals, and this indication, if sought for, may at least serve to place the operator on his guard. Treatment of Grave Hemorrhage.—It is assumed that the operator has made careful incisions, as elsewhere described, of such form as to favor the firm retention of gauze packing if required, and that he has carefully ligated all vessels of sufficient size to be conse- quential factors. Under these circumstances hemorrhage which cannot be controlled by ligature, direct application, or packing necessitates the employment of other more general measures. The position of the patient by raising the body or the head of the bed may be helpful. Clamping or ligation of the external carotid, the facial and lingual arteries will be described later (p. 440). Cold applications in the form of ice packs, cloths -^Tung in ice water and placed about the head, face, and neck, and heat applied to the extremities, are sometimes helpful expedients. Compression witliruhher hands aroimd the arms close to the shoulders and the thighs near the hips will be described later (p. 436). For internal medication, ergot administered internally, ergotin hypo- dermically, powdered ferropyrin in 20 per cent, solution, and other similar remedies have been quite generally used and recom- mended. In the author’s experience, however, they are not suffi- ciently effectiveto meetthe requirements of surgical mouth wounds in serious cases. Calcium lactate, 5 to 20 grains every three or four hours by mouth, suj)])lemented by thirty drops per rectum once or twice daily, seems to increase the coagulability of the blood