The Caledonian. [volume] (St. Johnsbury, Vt.) 1837-1867, 1839-02-12
NHHSCELLAN EOUS.
From the Baltimore american.
treat SURGICAL OPERATION.

Die operation Oh ",HmpHdtton o. INC 6otceT JdL
bone at ats JOINT successfully performed in this
city by Professor BuxIey, of the University OF
Mary land, has been handed to us by a medical
gentleman who was present on the occasion and
4ipon whose accuracy of description we can
confidently rely. While we rejoice to learn
that the occasions for such an operation are rare
we are also sgratifed to find that we possess
the skill adequate to the undertaking when the
sttuty ia required a:
" Mrs o. of this city, had for the last ten
months labored under disease of the face,
which had resisted the curative means of sever
Ill physicians whose professional aid had been
sought, and which rapidly increased until it
threatened to destroy life in few weeks The
right side of her face was occupied by a tumor
extending from the prominence of the cheek
bone downward below the edge of the lower
jaw, and from the right gle of the mouth to
the ear. embracing the right half of the lower
jaw from the chin TO its pos,erior Margin and
Tp to the socket where this bone unites 10 the
bone OF the temple, extending backwards into
the mouth as far as the palate and tonsils, up
wards involving the roof of the mouth and
downwards by the side of the tongue, which
Was pushed 10 the opposite side, so that the part
of the mouth not occupied by the tumor
filed up by the tongue as to render chewing i'm
practicable, and the swallowing even of fluids
difficult.
The family of the patient state that on Pro-
fessor Baxleys visiting the case, he Immediately
IL W Uo u tuinOT pTOOaDIy proceed
ing from the bone, constituting that form of dis
ease called osteosarcoma, and that he could adj
wise no means of giving her prospect of cure
short of tying the great artery of the neck and
removing the tumor itself. TIL patient, howev-
.er, could not summon the fortitude at the time
TO consent to so repusive an operation, and her
friends having learned that certain tumors of
the face had been relieved by tying the artery of
the neck alone, and being informed that such
was preliminary step to the operation proposed
by DR. Baxley, expressed desire to have that
done, in the hope that the circulation being cut
off, the tnmor might disappear. This was
cordingly done by DR.. b. on the 18th January,
ut the same time the patient was assured that il
afforded scarcely chance of cure, and that the
removal of the tumor was the only just grounl
of hope The facility and adroituess with
which this operation was performed, encouraged
the patient OH the next day 10 think that she
might bear the additional one recommended,
and on the 18th this undertaken by DR.
Bnxley in the presence of his colleagues, Pro-
fessors Howard and Dorsey, DR. G. NJ. Roberts
and others, and Mr. Rose, nt whose instance
DR. Baxley had been requested to see the pa
tent.
Before commencing this second operation it
was found that the circulation had been com
pletely established in the turnor from the yes-
sells of the opposite side of the hea8 and that the
arteries on the affected side were pulsated with
force no less than those of the other side, con-
clusively establishing the correctness of the o.
pinion that there was scarcely chance Of cure
from merely tying the carotid artery. This free
circulation made it necessary during the opera
ton to tie eight vessels, and cauterze several
more.
The operation was commenced at the right |
ANGLE of the mouth, and the first ncsion cut |
down to the turnor, and terminated on the neck,
n little beyond the point OF the ear. The next
incison commenced in front, and near the top Of
the ear and extended below this organ, ending
in the first incision.
All the parts above the first cut, and extending |
to the prominence of the cheek bone and those |
also below it, and reaching below the lower jaw
were quickly dissected off the tumor, which
was now completely exposed, and was indeed an
appalling spectacle.
the whole of the lower jaw bone from the chin
TO its socket above the middle of the ear; this
was accomplished by saving through the bone
at the chin disjoinng it at the sockets, and sep
arang it from its lateral and inferior attachments
throughout its whole length.
The third and concluding step of this extra
ordinary operation was the dissection of the re +
naming part of the tumor from its attachment
to the upper jaw and roof of the mouth, and as
tar back as the throat, which was speedily COM
pleted. .s.' .. .
Such was the astonishing firmness and self.
command of the suffering patient that she ut
tereu no complaint nor offered struggle during
either operation and if unparalleled endurance
on 'he part or the patient,and unsurpassed cool
ness and skill on the part of the surgeon in per
forming this delicate operation, can insure re-
covery, the prospect of Mrs O. is extremely
fattering. We learn on inquiry that she is now
-four days after the final operation,
WELL ll s,.H.t
1t is stated in Cooper's Surgical Dictionary
for 1886, that small portion of the lower law
have been removed by several eminent surgeons
but the great operation of amputating this Jaw
at the chin amt ITS JOINT, has never been perform
ed either in Europe or America except by the
distinguished DR. Mott, of New York, and DR.
Cossack, of Dublin. One other is men
toned 10y Delpeau, in which IN. Graefe, of
Berlin one of the most celebrated surgeons of
Germany, dared to disartcuate the lower jaw"
as in the present case" II