Alexandria gazette. [volume] (Alexandria, D.C.) 1834-1974, 1888-12-07
Triumph of Surgery.

Both the operation rt t;acbeot.my u j
that for the removal Of the ,aynx Usya
been performed in New York on ne ,ame
mon. The mau is now st tbs New York
Hospital, where be bss been since lte l-iynx
was taken out, over seven mouths age, CT
he is one OF the liveliest patients in lie insii-
tuition. His name is Joseph Liebrich and
he is a German laboreT. He was liv-
ing in obscurity in his native town Of Stas-
hourg when all Europe, and IN fact me
civilized world, vas talking about the file
ton that had befalleu bis sovereign He
came to America 10 October, 1887. Eariy
in December, 1887 be began 10 experience
q difficulty il breathing sod swallowing
which gradually increased in iutcnaiiy uutiI
it became almost unbsarable. Ho was cent
TO Wards Island Emigrsut Hospital, where
on February 10, 1888, tracheotomy was sue
cessfuly performed by DR.. Allen J. Thomas.
After this operation his difficulty in broath-
no inconv nvenence, be had gool appetiio,
and did not lose strength. But the cancer
GUS growth entirely filing the lsrynx he'd
been observed by DR.. Thomas at the time
of inserting the tracheal tube aad he ad
yised Liebrich to enter the New York Ho,
ptal under the care Of Or. ". t. Bull il
order that the larynx might be 70
moved. Liebrich finally consented TO
this, and on April 26, 1888, two and one
half months from the time the tracheot
omy was performed, tho complete extirpa'
ton OF the lsrynx was accomplished. Al
this time there was no enlarged cervicai
glands, the larnyx felt larger and fuller than
normal, but ita outlines we're moi disturbed,
though Its whole interior was fileG
with growth apparently staIting ffom the
right side The epiglottis was rot involved,
nor ths bali of the charynx. The anaesthe
tic used vas chloroform, aided by two hypo-
dermic injections OF morphire Tden q
vertical iDcision was msde in ths middle
line OF the neck crossed opposite the level
Of the hyoid bone by traverse cut through
the skin only. The prominent thyroid carti.
lege or Adams apple" was split 10 two in
order to ascertain the extent of the growth.
After opening the interior OF tn !arynX
the trechea about the tube was stuffed
tightly with small sponges attached to
strings. This device, together with keeping
the head lightly depended, effsctually ex
oludod all blood from the trachea or wind
pipe. The two halves of the larypx we're
removed separately, the separation being
made frat from the lower end. There was
trifiing bleeding, it being necessary to tie
only two or three arteries. For forty eight
hours after the operation no food passed
Liebrichs lips. BE was conscious, but did
not appear to suffer much. The mouth,
pharyn1, and wound were tightly plugged
with gauzs, saturated with idoform
Thirst was relieved by wetting the
lips and tongue, and nurishment was inject.
ed into the lower bowel, while the patient
breathed easily through the traohae tube,
which passed through the packing of gauSs
into the tracbe On the third day the
packing was removed and smaller amount
inserted and at the same time flexible
rubber tube was left In the oesophagu5, its
end projecting beside the trachael tube.
Through this nourishment-beef broth,
milk, and even lager beer and whisky-was
introduced into the stomach. A week later
the rubber tube was withdrawn, and after
ward inserted for q few moments only three
or four times each day, at the time of dress.
ing the wound.
This treatment was continued for about
four weeks, the patient gradually learning
to introduce the tube himself all the tine
the wound in the neck WAS gradually grow.
ing smaller, and the quantity Of gauze re.
quired to fill 1t was daily decreased The
tracheel tube was worn constantly, and will
always have to be worn now. The fifth
week Liebrch was allowed to swallow some
bread and milk, but the muscles of the
throat were unable to prevent portion
from entering the traohea, and it of cough
ing ensued. Further efforts were deferred
for day or two, but since then Liebrich has
been able to swallow with ease. He is also
able to speak, but 60 far only in hoarse
whisper He is robust and happy Seven
months have elapsed since the operation and
there is no sign of any return of the disease.
At least year must elapse before it can
be sure it will not reappear.