The Portland daily press., 1885-02-04
Delicate Surgery
The Revolution Effected by the New Am.
aesthetic.

A delicate and highly successful operation
was recently performed in New York by Dr.
Clarence G. Rice, which demonstrated the
wonderful advance that surgery has made in
the last few years, ard the peculiar adapta-
ton of the new an@sthetic, hydro-chlorate
of cocoaine, to CAGES of minor surgery. The
removal of tumor of this sort was formerly
a most serious affair and usually ended in
death. The patient first had to be ether
lied. AS preliminary step the windpipe
was opened externally and a tracheotomy
tube inserted therein, so that the patient
could breathe through it after the mouth
and throat had been packed firmly with cot
ton to prevent the blood from running into
the lungs. Then an incision was made
from point near the inner corner of the
eye, along the side of the nose, through the
upper lip, and the cheek was dissected up
and laid back from the bone. The upper
jaw-bone was cut through and section re-
moved, sufficiently large to permit the tu-
NOR and it was cut off or forcibly torn out
with forceps. The great danger was from
hemorrhage, on account of the large num-
Der of bloodvessels located in this region,
and great difficulty was experienced in bind
Ing ana Tying laCeraLeQ arteries IN Lne small
space exposed to view.
Surgical service has advanced to such an
extent that now, in the treatment of these
cases, at least, the surgeons knife, the eth
erizing cone and the dread that affected both
patient and surgeon alike, are happily laid
aside forever. The patient in this case, a
school teacher from Newark, came to the
surgeons office and was placed in an oper.
ating chair, and his head was pressed as far
backward as ease and comfort would permit.
The mucous membrane of the mouth,
throat, tongue, nostrils and rear nasal pas.
sage was painted with a small cameps hair
brush that had been saturated in a per
cent. solution of the hydro-chlorate of COCO
aine. This was kept up for about 10 min
utes, and the parts were found to be in
state of perfect anesthesia. An elastic
probe, to the end of which was fastened a
piece of whlpcord, was gently forced through
the left nostril until it appeared in the
throat. The cord was then seized with a
pair of forceps and drawn through the
mouth, one end being left suspended from
the nose. To this end fine piece of plat-
mum wire, bent in the form of loop was at
tached and slowly drawn through the nostril
until it was seen glisteniDg in the patients
throat. The tumor was then drawn
as far into the mouth as possible, and
the platinum loop was forced upward
around it, being pulled through the nostril
at the same time until it reached the point
where the tumor was suspended. That por-
tion of the wire which ran from the tumor
through the nose was insulated with two
small tubes that had been heavily wound
with silk thread, so that the only portion of
it that was exposed was that which touched
the tumor. The two ends of the wire, which
hung about six inches from the nostril,
were then attached to peculiarly construct
ed battery that was coupled to galvanic
casetory battery. By turning wheel and
rachet attachment, the platinum loop was
drawn tight around the neck of the tumor.
Everything being in readiness, an electric
current was sent through the wire. In an
instant the uninsulated section became
white hot, and smoke from the burning
flesh poured out of the mouth. The cur
rent was shut off in five seconds, and after
waiting until the wire cooled little, the
wheel and ratchet were worked, and the
loop was drawn through the baked flesh un-
til the patient indicated pain by contracting
the forehead. The process of heating, cool
ing aud tightening the loop was repeated
and continued until finally, by pulling gent
ly upon pair of forceps, which as pre-
caution had been fastened to the tumor,
through the mouth, to prevent it from fall
ing into the windpipe, the neck of the tu-
NOR was severed close to the point of union.
1t was pear-shaped, two inches long and one
and half inches in diameter. Five min
utes had elapsed from the time the electric
current was turned on to the end of the op-
GRAFTON; not drop of blood escaped. The
relief of the patient was immediate. His
mouth closed naturally, and for the first
time in many months he was able to breathe
through the nose. There was little exhaus-
tion from the shock, and in two hours the
patient was on the way home. Three days
afterward he was attending to his duties,
well man. The removal of naso-pharyngeal
tumors by the galvano-cautery has been
done but few times, and this case is the
first in which cocaine was used instead of
ether as an an@sthetlc. 1t did its work as
well as the ether could possibly have done,
and without the distressing after-effects.