The surgical treatment of the diseases of infancy and childhood / by T. Holmes.
- Timothy Holmes
- Date:
- 1868
Licence: Public Domain Mark
Credit: The surgical treatment of the diseases of infancy and childhood / by T. Holmes. Source: Wellcome Collection.
412/700
![June 5. I made a somewhat transverse incision, running obliquely upwards from near the tendon of the sternomastoid, across the pos- terior triangle to the margin of the trapezius, over the most convex part of the tumour. This incision was about five inches long. I then divided the parts freely down to the tumour, which lay below the cervical fascia, invested by a delicate membrane, forming a complete capsule for it. This I laid open very freely, and separated the tumour from it with my finger, or by strokes of the knife directed on to the substance of the tumour. Thus the mass was easily freed from all its [Fig. 58. Fatty tumour of the neck and axilla.] upper and posterior attachments. It was now seen to pass below the clavicle, and the omohyoid muscle was noticed beneath it. On lifting up the large mass, the lobe passing beneath the clavicle was easily drawn out of the axilla and freed from its attachments by careful strokes of the knife. Now a branch of the brachial plexus, apparently the suprascapular nerve, was met with passing across the tumour, and so imbedded in it as to require methodical dissection to free it. In order to clear the nerve, the large mass was cut away, leaving a few lobules which lay on the brachial plexus and subclavian artery. The root of the internal jugular vein was very clearly exposed for about an inch. Finally the lobules above mentioned were very carefully](https://iiif.wellcomecollection.org/image/b20416325_0412.jp2/full/800%2C/0/default.jpg)
