Savannah morning news. [volume] (Savannah) 1868-1887, 1885-01-31
REMOVAL OF A TUMOR.
COcOaine Used With EIectrIcity-Dr.
Rice's Delicate Operation by GaIvauo-

Rice's Delicate Operation by GaIvauo-
cautery in the Nasal Passage.
A delicate and highly successful opera
tion, says the New York Tribune of Jan.
%, was recently performed in this city
by DR.. Clarence c. Rice, a specialist in
throat diseases, which demonstrated the
wonderful advance that surgery has
made in the last few years and the pc
culiar adaptation Of the new anasthetic,
| hydro-chlorate of cocoaine, to cases of
minor surgery.
The patient, a mlddle-aged man. has
| been for many years a teacher in the
! public schools of Newark. For the last
| two years he has been troubled with a
! difficulty in the throat, which has been
| Yariously diagnosed by physicians, one
! prominent in the profession having pro-
nOunced ita case OF hay fever, and treated
| 1t as such. without, of course, effecting a
| cure, as the real difficulty was of an
! entirely different character. Medicine
| failed to give any relief, and the patient
! gradually lost flesh and strength until he
| became alarmed at his condition and came
| to this city for advice. Being seated in a
/ reclining chair in the surgeons office a
! powerful light was reflected from mir
| rOr, which was perforated through the
| centre, into the PATIENTS throat. By the
aid OF laryngOscOpe which is a small
mirror attached to a handle at nearly
right angle placed in the rear of the
mouth, the light was thrown into the rear
nasal passage, and a large tumOr was
| discovered. Its base was attached to the
mucous membrane at the top of the nasal
passage, just to the rear of the -WO OPEN
ings leading into the nose. The tumor
| had also grown forward into the lett nos.
trll, and covered the opening into the
right, so that no breath could be taken
through the nose, and the mouth hung
wide open nearly all the time. An Ope-
ration was advised and a week later aD-
pointed as the time.
The removal of a tumOr of this sort was
formerly most serious affair and usually
ended III death. The patient first had to
be etherized. AS a preliminary step the
WlndpIpe was opened externally and d
tracheotOmy tube inserted therein, so
that the patient could breathe through il.
after the mouth and throat had been
packed firmly with cotton, to prevent the
blood from running into the lungs Then
an lnclslon was made from a 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 removed suffi-
ciently large te permit the tumOr to be
handled. A knife was applied to the root
OF the tumOr and it was cut off or forcibly
TORN ouo with 1orceps. The great danger
was from hemOrrhage, on account of the
large number OF blood vessels located in
TINS region and great difficulty was ex-
perlence3 IN binding and tying Iacerated
arteries 10 the small space exposed to
view. Surgical science has advanced to
such an extent that now in the treatment
OF these cases, at least, the surgeons
knlle, the etherizing cone, and the dread
that affected both patient and SURGEON
alike are happily laid aside forever.
The school teacher came again TO the
surgeon S Office, and was placed in an Op-
Grating chair, and his head was pressed
as far backward as ease and comfort
would permit. The mucous membraneOf
the mouth, throat, tongue, nOstrIls. and
rear nasal passage was painted with A
small cameFs hair brush, that had been
saturated in per cent. solution of the
nydrO-chl0rate OF cOcoaine. This was
kept up for about ten minutes. and the
parts were found to be in a state of per-
fect an1sthesia. An elastic probe. to the
END OF which was fastened piece of Wbip
cord, was gently forced through the left
nostrll until it appeared in the throat.
Inc cord was th1 II seized with a pair of
lorceps, and drawn through the mouth.
one end being left suspended from the
nose. To this end a fine niece
OF platinum wire bent in the
form OF loop was attached, and slowly
draWn through the nOstrl until it was
seen gIlstenlng in the PATIENTS throat
Inc tumCr was then drawn as far into the
mouth as possible and the platinum loop
was forced upward around it, being pulled
through the nOstriI at the same time. until
it reached the point where the tum0r was
suspended. That portion of the wire
Whlch ran from the tumOr through the
nose was insulated with two small tubes
InaU had been heavily wound with silk
thread, so that the only portion of il that
was exposed was that which touched the
tumor. The two ends Cf the wire. which
huhg ABOUT SIX inches from the nOstriI.
were Inen attached TO a peculiarly con-
structed handle that was coupled to n gal-
VanO-cautery battery. Bv turning a
Wheei and ratchet attachment the plati-
mum loop was drawn tightly around the
neck of the tumOr.
Everything being in readiness. an cleo
trlc current was sent through the wire.
In an instant the uniDsulated section be-
came Whlte hot, and smoke from the
hurnlng flesh poured out Of the mouth
The current W as shut off in five seconde
ana after waiting until the wire cooled a
niue Ine wheel and ratchet were worked
ana the loop was drawn through the
baked nesh, until the patient indicated
pam by contracting the forehead. The
process OF heating, cooling and tighten
ing the loop was repeated and continued
untlI nnally, by pulling gently upon
par OF torceps, which as a precautIon had
been fastened to the tumOr through the
mouth to prevent it from falling into the
wlndpipe, the neck Of the tumor was
severed close to the point of union. II
was pear-shaped, two inches long and
one and half inches in diameter. Five
minutes had elapsed from the time the
electric current was turned on to the end
OF the operation. Not a drop of blood es.
capped.
The relief of the patient was immediate,
His mouth closed naturally and for the
lrst time In many months he was able to
breathe through the nose. There was
little exhaustion from shock, and in two
hours the patient was on his wav home.
Inree days afterward he was attending
10 MS duties, we'll man.
The removal of nasO-pharyngeaI tumOrs
by the galVanO-cautery has been done but
lew times, and this case is the first in
which cocaine was used instead cf ether
as an an8othetic. 1t did its work as well
as the ether could possibly have done, and
without the distressing after effects.