Iowa County democrat. [volume] (Mineral Point, Wis.) 1877-1938, 1885-07-17
CANCER.
The Life History of Epithelioma of the
Tongue.

The Life History of Epithelioma of the
Tongue.
Although scirrhous carcinoma of the
tongue is occasionally met with, the
most important of the neoplasms of
that organ is epithclioma, the natural
history of which has a special interest
at this tine, in connection with the
case of a distinguished citizen, in
hjch minute examination has dis
closed that the disease is cancer of
that type.
Lingual epithelioma. rs rule, rap
idly progresses toward Il fatal termina-
ton. When left to itself, the life of
the pat ent from the first appearance
of the disease varies, in accordance
with the estimates of different observers,
from 10.5 to thirteen months. the av-
era@e being ILL., months. Death en-
sues, first, from the generalization OF
the disease; secondly, from septic pneu-
monia. from the inhalation of the pu-
TT Il emanat ons which result from the
decompoS;t' on OF the products OF the
liberated surface; tn rdly, from starva-
on, through the pressure of the in
fectc lymphatic glands and surround
ing parts upon the Gsophagus. there
by interfering with deglutition, and
lastly. from hemorrhage proceeding
from the liberated lingual arteries, or
til vessels of the neck.
The duration of life of those who
survive an operat on averages nineteen
months. Not only dos operative in
terfc ,encn prolong life I'd relieve sVf-
frlfnr, but it effects Il final cure in four
teen per cent, OF all eases. In attain
no these results it must, however, he
rcmrm herei that eNcision of the tongue
is att nndc with mortality of twenty
three per cent. the principal dangers
being shock. hemorrhage. udema of
tn. glottiS, septic lung affections.
pv;emia and ervSipelas. some of which
r.S'l, can he avoided by taking careful
precautions during the operation, and
by thu perfcct:ng of antiSeptic meas
urcs dur M and after the procedure.
When in addition to d sease of the
tonga" itself, the palate and the tonsil
are iavo V ii. the prognoSis is far more
gave whether the disease b. permitted
10 prrS e an una;ded course, or whether
b. subjected to the knife. In the lat
ter event, not only will the tongue have
to be eXtirpatea but the disease of the
palate and tonSil will have to be
reached ether by Langenbeck' or
NJ kuiicH's m thod of operation. In
the former. the jaw-bone is divided
Just in front of the masseter muscle,
while. in the latter, the ramis of the
aw is rcsected. For carcinoma of the
tons alone temporary section of the
Interior maxilla has been practiced by
Cheever, Gensmer and Won Bergman.
In Cheever'S case the disease continued
to progress; IN Gensmer's Iere was
freedom from recurrence for thirty
three months VIII lie we are not aware
of the fate of Won Bergman patient.
In NJ kulicz' case of resection of the
ramus the patient was well at the ex-
piration of six months
SO far as we can earn there is no ex-
ample of the performance of the double
operation on record. and it is, in our
opinion, not justiliable. The only
ava liable measures are those directed
toward the relief of suffering, the pre-
vent;on of septic complications and
supporting the powers of the system
Should deglut:tion be greatly interfered
with gastrostomy might be resorted to,
but this procedure, under the circum-
stances. is of such a questionable ma
ture that the prudent surgeon would
doubtless not take it into cons;dera-
ton Philadelphia KedtcG! Journal.