A case of tracheotomy for multiple neoplasms of the larynx : clinical lecture delivered at Jefferson Medical College Hospital / by J. Solis-Cohen.

  • Solis-Cohen, Jacob da Silva, 1838-1927.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: A case of tracheotomy for multiple neoplasms of the larynx : clinical lecture delivered at Jefferson Medical College Hospital / by J. Solis-Cohen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    until you feel the carotid arteries beating under them. Then, without removing your fingers, make your incisions Avith the right hand in the middle line until you reach the windpipe. The pressure of the fingers and thumb of the left hand will continually force the windpipe for- ward and facilitate your manipulations. When the trachea has been reached, you can release the pressure and complete your operation at more leisure under the proper indications. This is Durham's opera- tion. [^Subsequent History.—The patient passed the most comfortable night after the operation that he had passed for six months, and in the morning ate the heartiest meal he had eaten for the same period. A few days later, on making a laryngoscopic examination, the epiglottis was found erect, so that there was no difficulty in confirming the ob- servation that had been made under difficulty the day before the tracheotomy. Usually the epiglottis is more depressed after trache- otomy than before. The reverse condition in the present instance is probably due to cessation of some suction effect of the inspiratory cur- rent through the occluded larynx, which has ceased to be exercised since the artificial opening was made below it. On the tenth day a mass of morbid growth the size of the end of a finger was readily removed with forceps under laryngoscopic inspec- tion. This mass was transferred to the pathological department of the hospital for investigation, and was reported to be inflammation-tissue. Similar reports were made of the subsequent masses removed. Never- theless, the clinical aspects of the case rapidly presented acute tubercu- losis with failure of cicatrization of the tissues whence the morbid growths were removed. I must confess that I am at a loss to classify these growths. Macroscopically and laryngoscopically I should have termed them papillomas.]