Extirpation of a tumor of the parotid : with observations upon the pathology of that gland / by Alexander E. Hosack.

  • Hosack, Alexander E. (Alexander Eddy), 1805-1871.
Date:
[1844?]
Catalogue details

Licence: Public Domain Mark

Credit: Extirpation of a tumor of the parotid : with observations upon the pathology of that gland / by Alexander E. Hosack. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    which a small aperture existed ; and through this the fluid receded, but reappeared immediately upon the discontinuance of the pressure. The whole tumor was rendered more prominent and tense, upon opening the mouth, in consequence probably of its being pressed outwardly by the angle of the jaw. Not being able to come to a definite conclusion as to the true character of the disease, I determined to make a small valvular opening to ascertain the nature of its contents. This revealed about a table-spoonful of a thin, amber-colored fluid of the consistency of the serum of the blood. During its flow, the color was twice suddenly changed to that of dark black, and it as suddenly returned to its original hue. There was no disposition in them to unite, the two having no affinity, as both remained separate and distinct in the cup in which they were received. The black matter was much darker than the darkest blood found in the veins of bodies, that have been some time in the dis- secting room—a fact that will be more fully adverted to in the sequel. I will, therefore, proceed to describe the operation, which was done on the 16th December, about ten days after the above examination, as- sisted by my friends, Drs. J. K. Rodgers, Wilkes, Minturn Post, and Van Rensselaer, and in presence also of several pupils. The patient being placed in a chair, an incision was commenced be- hind the conch of the ear, which was extended quite down over the tumor, terminating in the sound structure of the neck. A second incision was begun directly below the lobe of the ear, and carried over and below the tumor, where it joined the first. Upon detaching the integument on either side, and exposing the surface of the tumor, the prominence before alluded to presented a very black appearance, in all respects resembling that of melanosis. Progressing with the dissection on the side toward the face, I very soon came upon the anterior portion of the parotid gland, which, from its great vascularity and granulated structure, was immedi- ately recognized ; but it was found to be so intimately blended with the tumor as to leave no doubt that this gland was the seat of the disease. After having detached the integument on the opposite side of the tumor, I proceeded with great caution, making my way beneath it in search of the external carotid artery, which was distinctly felt pulsating directly within the digastric muscle ; and finding this vessel to enter into, or at least to adhere to, the diseased mass, I determined to secure it at this point. I consequently placed two ligatures upon it, and divided it in the interspace. In consequence of the tumor being much reduced by the discharge of the fluid through the small opening made into it, it could readily be drawn in various directions, which greatly facilitated the re- maining and most dangerous part of the operation. The diseased mass was now grasped with a double hook, and pulled downward and outward, while I dissected on, carefully advancing toward the extremity of the conical point of the inward extension of the parotid gland. It was at