Amputation of the entire lower jaw, with disarticulation of both condyles / by Henry J. Bigelow.

  • John Murray Carnochan
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: Amputation of the entire lower jaw, with disarticulation of both condyles / by Henry J. Bigelow. Source: Wellcome Collection.

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    The amount of blood lost was inconsiderable; the arteries divided, besides those mentioned, were the transverse facial, the anterior masseteric, the anterior parotidean, &c.; and these were secured as soon as divided. The bone being disarticu¬ lated, the flaps were adjusted, and the lips of the incision united, by eighteen points of twisted suture. The tongue was retained forwards after the dressing, by attaching the ends of the ligature already passed through its base, on each side, to a bandage passed vertically around the head. Forty- eight hours after the operation, the first dressing was re¬ moved. Union by first intention had taken place, and eight of the suture-pins were taken out. In ninety-six hours, the wound was again examined. Union wTas found to be en¬ tirely completed, and the remaining pins were removed. On the seventh day, it was thought safe to remove the ligature from the tongue. On the tenth day, the arterial ligatures came away; and on the fourteenth day, the patient was pro¬ nounced cured; not having had an untoward symptom since the performance of the operation. The operation occupied fifty-five minutes, the patient hav¬ ing been allowed intervals of repose to recruit. It was per¬ formed in the presence of a number of professional gentle¬ men ; and I was ably assisted by my colleague, Dr. A. Y. Williams, by Drs. Dewees and Dixon, of New-York, and by Drs. Thompson, Whitehead, Smith and Bailey, resident as¬ sistants attached to the surgical staff of the Hospital. The present appearance of the patient, upon reference to the accompanying plate, Ho. 2, will be seen to present much less deformity than might be expected from the severe muti¬ lation which he has undergone. His general condition and health are good; and he is now able to perform any ordinary vocation. The ducts of Steno, on both sides, were necessarily divided in the superficial incisions; but there is no salivary fistula, the saliva taking its course into the mouth. The di¬ vision of the branches of the facial nerve has not been fol¬ lowed by paralysis of the face; although for a time after the reunion of the incision, the orbicularis palpebrarum of the right side appeared to have lost its action to some extent. In grasping the chin, a thin cartilaginous deposit can now be