Fort Worth daily gazette. (Fort Worth, Tex.) 1882-1891, 1888-12-08
TRACHEOTOMICAL.
A Wonderful Surgical Operation Per-
formed in New York Hospital.
A LarynxleSS Man.
Emperor william Should Have Had an Ameri
can SurgeOn-The Story Of the
Recent Operation.

NEW YORK, Dec. 3.-Both the opera
ton of tracheotomy and that for the re-
moval of the larynx have been performed
in this city, and on the same man. The
man is now at the New York hospital
where he has been since his larynx was
taken out over seven months ago. And
he is one of the 1iveliest patients
in the institution. His name is
Joseph Liebreich and he is German Ia
borer. He was living in obscurity in his
native town of Strasbourg when all
Europe, and in fact the civilized world
was talking about the affliction that had
befallen his sovereign. He came to
America in October, 1887. Early
in December, 1887, he began
to experience difficulty in
breathing and swallowing, which
gradually increased in intensity until it
became almost unbaerable. He was sent
to the Ward S island emigrant hospital +,
where, on February 10, 1883, trach9to-
my was successfully performed by DR..
Allen ] Thomas. After this operation
his difficulty i'll breathing disappeared /:
The traeheal tube gave no Inconvenience,
did not lose strength But the
cancerous growth entirely filing the
larynx had been observed by DR.. Thomas
at the time of inserting the tracheal
tube, and he advised Liebreich to enter
the New York hospital under the care of
DR.. Bull, in order that the larynx might
be removed. He finally consented TO
this, and on April 26, 1888, two and one
half months from the time tracheotomy
was performed, the complete eXtirpation
Of the larynx was accomplished.
At this time there were no enlarged
cervical glands, the larynX felt larger
and fuller than normal, but its outline
was not disturbed, though its whole in
terror was filed with a growth appar-
emily starting from the right side. The
epiglottis was not involved, nor the wall
of the pharynx. The an9sthetic used
was chloroform, aided by two hypoder-
mic injections of morphine. Then YER
teal incision was made in the middle line
OF the neck, crossed opposite the level of
the hyoid bone by a transverse cut
through the skin only. The thyroid car.
tilage, or "Adam's apple, - was first
split in two in order to ascertain the ex-
tent of the growth. After opening
the interior of the larynX the
trachea about the tube was
stuffed tightly with small sponges
attached to strings. This device together
with keeping the head tightly depended,
effectually excluded all blood from the
trachea or windpipe. The two halves of
the larynx were removed separately, the
being made first from the
lower end. There was trifing bleeding,
it being necessary to tie only two or three
arteries.
For forty-eight hours after the opera
lions no food passed his lips. He was
conscious, but did not appear to suffer
much. The mouth, pharynx and wound
were tightly plugged with gauze saturated
with iodoform. .... -r.-
Thirst was relieved by wetting the lips
and tongue, and nourishment was in
jected into the lower bowel, while the
patient breathed easily through the
tracheal tube, which passed through the
packing of gauze into the trachea.
On the third day the packing was re-
moved and smaller amount inserted,
and at the same time a flexible rubber
tube was left in the oesophagus,
its end projecting beside the
tracheal tube. Through this
- beef broth, milk
and even lager beer ana WhlsEy-WaS IN
troduced into the stomach. a week
later the rubber tube was withdrawn and
inserted for Il few mo-
ments only three or four times each day
at the dressing time of the wound.
This treatment was continued for about
four weeks the patient gradually learning
to introduce the tube himself. All the
time the wound in the neck was gradual
" growing smaller, and the quantity of
gauze required to fill it was daily less and
ess. The tracheal tube was constantly
md will always have to be worn
now. On the 5th Liebreich was allowed
10 swallow some bread and milk,
out the muscles of the throat were
unable to prevent a portion from enter
ng the trachea, and a fit of coughing en-
sued. Further efforts were deferred for
, day or two, but since then Liebreich
mas been able to swallow with
ease. He is also able to speak but so far
onIy in a hoarse whisper. He is robust
md happy. Seven months have elapsed
.ince the operation, and there are no
'igns of any return of the disease. At
east year must elapse before one can
De sure that it will not reappear-