The Iola register. [volume] (Iola, Allen County, Kansas) 1875-1902, 1885-05-15
CANCER.
The LIE History Of Epithelioma OF IL
Tongue.

The Lie History Of Epithelioma OF IL
Tongue.
Although scirrhous carcinoma of the
tongue is occasionally met with. the
most important of the neoplasms Of
that organ is epithelioma, the natural
history of which has special interest
at this time, in connection with the
case of distinguished citizen, in
which minute examination has dis
closed that the disease is o cancer of
that type.
Lingual epithelioma. as a rule. rap
idly progresses toward fatal terminus
ton. When left to itself. the life of
the patient from the first appearances
of the disease varies. in accordance
with the estimates of different observers,
from 10.5 to thirteen months. the av-
erage being ILL., months. Death en-
sues. first, from the generalization OF
the disease: secondly. from septic pneu-
monia, from the inhalation of the pu-
trid emanations which result from the
decomposition of the products of the
liberated surface; tn rdly, from starva-
ton. through the pressure of the in
fected Emphatic glands and surround
ing parts upon the 9sophagus, there
by interfering with deglutition. and
lastly, from hemorrhage proceeding
from the liberated lingual arteries, or
the vessels of the neck.
The duration of life of those who
survive an operation averages nineteen
months. Not only does operative in
reference prolong life and relieve SUI
fering, but it effects final cure in four
teen per cent. of all cases. In attain
ing these results it must, however, be-
remembered that excision of the tongue
is attended with a mortality of twenty
three per cent. the principal dangers
being shock. hemorrhage, Gdema OF
the CLOTHS. septic lung affections.
pvamia and erysipelas. some of which
risks can be avoided by taking careful
precautions during the operation. and
by the perfecting of antiseptic meas
ures during and after the procedure.
When, in addition to disease of the
tongue itself, the palate and the tonsil
are involved. the prognosis is far more
grave, whether the disease be permitted
to pursue an unaided course, or whether
it be subjected to the knife. In the lat
ter event, not only will the tongue have
to be extirpated. but the disease of the
palate and tonsil will have to be
reached either by Langenbeck's or
Mikulicz's method of operation. In
the former. the iaw-bone is divided
just in front of the massetpr muscle.
while. in the latter. the ramus of the
Jaw is resected. For carcinoma of the
tons alone temporary section of the
Interior maxilla has been practiced by
Cheever. Gensmer. and Won Bergmann.
In Cheever's case the disease continued
to progress; n Gensmer's tiere was
freedom from recurrence for thirty
three months VIII lie we are not aware
of the fate of Won Bergmann's patient.
In M ku'icz's case of resect!on of the
ramus the patient was well at the ex-
piratiOn of six months.
So far as we can learn there is no ey-
ample of the performances of the double
operation on record. and it is. in our
opinion, not justifiable. The only
ava liable measures arc those directed
toward the relief of suffering. the pre-
vention of septic complications and
supporting the powers of the system.
Should degluttion be greatly interfered
with gastrostomy might be resorted to,
but this procedure. under the circum-
stances. is of such questionable ma
ture that the prudent surgeon would
doubtless not take it into cons;dera-
ton. PHILADELPHIA Medical Journal.