On resection of the Gasserian ganglion, with a pathological report on seven ganglia removed by W.W. Keen.

  • William Williams Keen
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: On resection of the Gasserian ganglion, with a pathological report on seven ganglia removed by W.W. Keen. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    cells are diseased, any stimulus from the first division will excite sensation in them, and thus may bring about a return of the pain. As the only objection to removing the whole ganglion — the effect upon the eye — can now, I think, be overcome, we ought, I believe, distinctly to aim at the removal of the entire ganglion. III. Shall the ganglion be removed as a primary ope- ration — the very first after the disease has set in —, or shall it be left till the last operation: that is to say, shall we perform as many peripheral operations as can be done first, and only remove the ganglion when we are driven to it? I believe that this last is the proper position to take. While Prof. Spiller, from his investigations of the pathology, is not able to say positively whether the ganglion becomes diseased primarily or secondarily, yet as he points out, the clinical evidence would lead us to believe that the ganglion is the last of all to suffer. Of course, after any peripheral operation, just as after an amputation of an arm, dege- nerative changes will set in wich will go direct to the Gasserian ganglion, and may, so far as we know, reach to the pons, or even possibly the cortex, just as after an amputa- tion of the arm, degenerative changes can be traced into the central nervous system; yet these are very different from anything like an ascending neuritis, which would involve the ganglion in inflammatory troubles as a result of the preceding disease of the nerve branches. The effect on the ganglion, even after eighteen years of suffering, in Case VIII, was very slight. This, so far as I know, is the only examination of a ganglion in wich no peripheral operation had been done, and in which the exa- mination is, therefore, free from any suspicions of alteration in the ganglion other than that due to a possible ascending neuritis. It must be stated, however, that the entire ganglion
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