This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1896 Excerpt: ...to the following four chief points, viz.: (1) the question of preliminary tracheotomy; (2) the control of the bleeding; (3) the removal of the glands; and (4) the methods of gaining access to the primary cancerous mass. After considering these points, I shall then refer to the after treatment and the results. (1) The ...
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This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1896 Excerpt: ...to the following four chief points, viz.: (1) the question of preliminary tracheotomy; (2) the control of the bleeding; (3) the removal of the glands; and (4) the methods of gaining access to the primary cancerous mass. After considering these points, I shall then refer to the after treatment and the results. (1) The question of Preliminary Tracheotomy.--It is, of course, an advantage, if one can manage it, to avoid preliminary tracheotomy, for that adds additional complications in several ways. In the first place, it means another wound which must become septic, it means irritation of the trachea by the presence of the tube and the admission of cold air, and it also means very distinct interference with coughing and the power of expelling any discharges which may have entered the larynx. In one of my cases (No. 26) I was able to remove the disease satisfactorily without performing tracheotomy, but here it was located towards the upper part of the tonsillar region, anterior pillar of the fauces, and the soft palate, and the lower part in the neighbourhood of the orifice of the larynx was quite free. Further, the external carotid artery had been tied, so that, partly as the result of the situation of the tumour and partly as the result of the absence of bleeding, there was no need for tracheotomy. In Case 22 I tried to do without tracheotomy in the first instance, but when I came to deal with the tumour in the throat, I found that there was no room for my manipulations inside without completely blocking the breathing space, and therefore I had to perform tracheotomy in the middle of the operation. No doubt, in cases where the external carotid artery is ligatured, and the bleeding is consequently very small, there is not much chance of blood entering the trac...
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