The Arkansaw traveler., 1889-01-19
REMARKABLE SURGERY.

and that tor the removal OF the larynx
have been performed in this city and
on the same man. The man lie now at
the New York Hospital, where he has
been since the larynx was taken out
extirpated, as the surgeons would say
over seven months ago, and he Is
one of the liveliest patients in the In
stitution. His name Is Joseph Lieb-
rich, and he is only an humble German
labOrer. lie was living in obscurity
in his native town of Strasbourg, when
all Europe and, in fact, the civilized
world was talking about the aflliction
that had befallen his sovereign. lie
came to America on October 2, 1887.
Early in December, 1887, he began to
experience a difficulty In breathing
and swallowing, which gradually
increased in intensity until il became
unbearable. He was sent TO the
Wards Island Emigrant Hospital,
where, on FEBRUARY 10, 1888, tracheo-
tony was successfully performed by
DIR. Allen J. Thomas. After this
operation his difficulty in breathing
disappeared. The tracheal tube gave
no inconvenience and he had a good
appetite and did not lose strength.
But the cancerous growth entirely
filling the larynx had been observed
by DIR. Thomas at the time of insert
ing the tracheal tube, and he advised
Liebrich to enter the New York
Hospital under the care of DIR. w. T.
Bull, in order that the larynx might
be removed. Liebrich finally consent
ell to do 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
interior was filled with growth
apparently starting from the right
side. The epiglottis was not involved
nor the wall of the pharynx. The
anesthetic used was chloroform, aided
by two hypodermic injections of
morphine. Then q vertical incision
was made in The middle line of the
neck, crossed opp >site the level of the
hyoid bone by transverse cut though
the skin only. The prominent thyroid
cartilage, or Adams apple" was
first split In two In order to ascertain
the extent 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 lightly depended,
effectually excluded all blood from the
windpipe. The two halves of the
larynx were removed separately, the
separation being made first from the
lower end. There was trifliDg bleed
ing, 1t being necessary to tie only two
or three arteries.
For forty eight hours after the
operation no food passed Liebrich's
lips. He was conscious, but did not
appear to suffer much. The mouth,
pharynx and wound were tightly
plugged with gauze, saturated with
iodoform. Thirst was relieved by
wetting the lips and tongue, and
nourishment was injected into the
lower bowel, while the patient breath
ed easily throug the tracheal tube,
which passed through the packing of
gauze into the tracheal.
On the third day the packing was
removed and q smaller amount insert
ed, and at the same time q flexible
rubber tabe was lett In the esophagus,
Its end projecting beside the tracheal
tube: Through this nourishment-