The first lines of the practice of surgery: designed as an introduction for students and a concise book of reference for practitioners (Volume 2).

  • Samuel Cooper
Date:
1835
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Licence: Public Domain Mark

Credit: The first lines of the practice of surgery: designed as an introduction for students and a concise book of reference for practitioners (Volume 2). 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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    passing a double ligature through this organ, arid firmly tying one part of the ligature over each side of it. This plan must be infinitely more painful, than the removal of the diseased part with a knife. To the latter method, the hemorrhage is the only objection; and notwithstanding all that has been said, I think no surgeon ought to venture to cut away a diseased tongue, without having first made up his mind, re- specting what method should be adopted for stopping the bleed- ing.* When much of the tongue has been lost, its functions may be rendered very imperfect. However, numerous cases are re- corded, in which the greater part of this organ was lost, and yet the patients retained the faculties of tasting, masticating, swal- lowing, and articulating words, with considerable perfection.t The removal of scirrhous and sarcomatous tumours of the tongue may be most conveniently accomplished with a scalpel and a tenaculum. Encysted swellings of this organ are gene- rally of the meliceris kind, and ought, if possible, to be dissect- ed out, without opening the cyst at all.J Authors relate examples in which the tongue was of extraor- dinary magnitude, either in consequence of original malforma- tion, or disease. Excepting the deformity, some of the patients experienced no particular inconvenience, as they could speak, masticate, and swallow tolerably well.§ Under these circum- stances, the removal of the redundant portion would not be ad- visable; but if the disfigurement were combined with much in- convenience, the operation ought to be performed. * | The bleeding might be in a great measure restrained by securing the lingual arteries, as they run parallel to the horn of the os hyoides, where they are comparatively superficial and easily reached, not covered by mus- cles, and only connected with the lingual nerve,] | See Mem. Physiologique, &c. sur la Langue par M. Louis, in Mem. de l'Acad. de Chirurgie, torn, xiv. edit. 12mo. % Schmucker describes the extirpation of a large encysted tumour of the tongue, the appearance of which had excited suspicions of the patient hav- ing two tongues. See Vermischte Chir, Schriften, band, iii, p, 323, § Sandifort's Obs.