New-York daily tribune. [volume] (New-York [N.Y.]) 1842-1866, 1859-01-21
phaynI and larynI 10 unim portast and the mis-
stake of no great consequence. Let Us eco:

In the first pls.e, the certainty OF oss blsalsr
suggest, The possibility Of secoad. Surgeons Are
not infalible, and be who mskes q, error ia
dsgposis may possibly make another in apo
mor'em examinat on. la seeking fora lesioa 10 q
the lsrypx they fund one in tie phaynI. Ish
not impossible that it was ruade with their OF,
instruments This perforatiou, they tell u.s. opsssi
through the phsrynx into the abscess Ye. that
absce,s vas as large q, an egg. and WAS no sooner
opeped than tie matter with which il Was 6asl
exuded. But they seem TO forge! when tasy
tell us this that there was already an opening i,ts
that sbscess Why did not the pus escape through
the ore already made How was it possible fsr
an abscess already opened to re.Sa its coateat,f
There are two explanations Of this difficulty. 0ss
ia that there was no opening at all into the
abscsss till they made one, when the pas
escaped; and that the opening into the
pharypx, which they subsequently mentioa -
ouud, was accidentally made by themselves.
The other explanation. perhaps, is the more
probable and correc. one. Dr. Carl Rcsitaasky,
the Curator of the Imperial Pathological Museum,
and Professor at the University Of Vienna, aniver
ally acknowledged IS the best authority oaaay
question of pathological anatomy, says;
"In the exsminstion of the dead BODY, we have
occasional opportunities of noticing pecuhsr form q
suppuraion in toe atynx undoubtedly resulting uom
Inflammation that bad commenced in the periooon.
drum which appears 10 be detached either al circam-
scribed scots, or more commonly over oote sutiAoes
Of NhCle cartilage and under TINS quanu'y " +"
il found collected IN membranous sac.
Tbs abscsss may make ITS roy tHto me tarya1 raeso
or thGJyA may ereE open ana discharge s' eSs-
tents externally
Here was sach an abscess and as the natural
end Of al assesses is 10 fDd an outlet this my
have opened such an outlet for itself into the
pharynx, aud by its overflow have inevitably pro
duced the asphyxi, of which the patient died. IL
was perfectly natural termination of the disease.
and the most probable explanation of the case.
We come then to this conclusion: either there was
no sion Of the pharynN till after DEATH else tao
pus would have escaped; or there was lesion
made by the disease itself just before death, when
the pus did escape aud sufocated the paaens In
either case the perforation could not have been
made by Dr. Green. We think this must commend
itself to the common sense of everybody.
But satisfactory as il IL, it is not the only reason
for supposipg that an error has been committed in
sttributirg the lesion to DR.. Green's probang. IL
is TO be borne ia mind that the pharynK ia tho
passage above the esophsgus which leads 70 the
stomach. There lie behind the larynx and tricaea
| the parts which DR.. Green was submitting TO
| treatment The abscess was between the pharynx
and the lsrynx; and the opening into the pharyH
from the ab.cess in the upper poserior part oil
| the "abscess." Consequently, it was In the az
terror wall of the phapnx. Now, any man can
see, by moments reflection, that, IL the proosag
should by mistake enter the pharynx instead OF
tie lapnx, its natural course would b
10 strike the posterior wall of that organ, aud
not T. anterior, it must have done to
pierce the posterior part OF the sssce"L 10
make q hole IN the anterior wall Of the pharynK,
We must suppose the probang to DO hook aud
pulled forward, aud not slightly bent instrument,
which is passed downward and backward. The
end Of the probaDg, moreover, is guarded bye
spoDge, and we have the testimony Of DIR. Fy,
who was present at the operation, that this sponge
vas passed downward and Immediately withdraw
when the patient complained that it hurs him.
That it did hurt there be no doubt for tho ABB
scess probably was at that moment forming, and to
touch it was painful, as many man can testify
who has discovered the existence Of an inciPent
boil by a touch. II seems, then, certain, apart
from the improbability Of there having been any
lesion in the pbarynx TIL just before death, II at
all. and in which case, its breaking caused sufoct
ton it seems cntain that DR., Green could not
possibly have made any perforaton in the place
where. it is said, it was found with the probang
Il is simply physical impossibilty that tissue oil
such tenacity could have been broken through with
such an instrument.
This is not the place 10 discuss the question OF
topical treatment by nitrate of silver. That BE-
longs TO msdi:al journals. We may, moreover, DO
held excused from it, in this ease, inasmuch az Dr.
Beales virtually confe,ses be knows nothing aeous
it. We cannot, however, refrain from calling AZ
tention to single point The post morton examI
nation revealed cavity in the lungs at the root OF
the bronchial notifications, through which was an
opening into the pleura. The conclusion sus'
Qested is that this was caused by the nitrate u
silver injected by DR.. Green. But Dr. Green hso
Injected no nitrate of silver for several weeks.
while DR.. Mott, 70 says DIR. Besles, had informed
the family that there was no disease which may
lot have originated within a week. There
manifest discrepancy. Nor is this all DIR. Beai"
ssys in his statement that the cavity was scoop
ipQ.out of the apr of the lang The apex The
apex is several inches abore the bronchial ramihes-
tion., and where an injection Of nitrate OF silver
could never reach.
Perhaps zee shall be accused ofa want OF dell
/" cacy" to ward ply sicians but we cannot re'fan
from expressing our surprise, more emPhaticaliy