Arizona republican. [volume] (Phoenix, Ariz.) 1890-1930, 1899-09-07

, presented the patient before the
LaTyn geological society. The swelling
in the throat was about the size OF a
hens egg, and was situated just I'M
der the ear. If the swelling was
touched the patient always began to
cough violently. Fellows preferred to
speak in whisper, but when he was
asked to try to talk he was able to
speak little louder, though very
huskily and painfully.
Because of the pain and suffering
which Fellows had undergone he was
advised ito submit to an operation, 50
that the nature CT the swelling could
be positively determined. The surgeons
had no reason to suppose that there
was anything dangerous in the under
taking, and they told Fellows so. He
readily agreed to allow the operation
to be performed.
DIR. Stansfield Collier, who operated
made a small exploratory cut just at
the angle of the jaw and dissected
gently down until the swelling was
reached.
Then, fer the first time, the surgeon
understood and appreciated what
tremendous task lay before him.
The swelling was no mere gldndular
enlargement, as had seemed probable,
but was, instead, a malignant tumor.
A little more dissection Showed that
the tumor was inextricably involved
with the sheath of the carotid artery
and that the growth also surrounded
the jugular vein and the big pneumo-
gastric nerve.
Mr.. Collier, with hardly an instant's
hesitation, decided to attempt the op-
Grafton
AS it was necessarily impossible to
incise the carotid artery or Jugular
vein without in some way checking the
flow of blood, there ives a consultation
as to how this should be done There
is an instrument which is sometimes
used by surgeons which presses on
both the carotid artery and the jugular
vein and checks the flow of blood suffi-
GENTLY to prevent dangerous hemCT-
rhage in operations on the head, but
Mr. Collier thought this would not be
safe enough for the purpose of the
work he had in hand.
He determined to ligate both the
carotid artery and the jugular vein
that is to say, to tie up both artery
and vein 50 that no blood could pass
through them.
simultaneously he made up his mind
that it would be necessary to remove
part CT both the vein and the artery
and that, in all probability, a piece of
the pneumogastric nerve would have
to be cut away as well.
This meant that the circulation of
blood from the heart through the ar
terry and vein would be stopped for
good. Some parts Of the body can be
repaired, but there is net yet known
any way by which a missing piece OF
pifh0T "a RI or ho
piled.
Ligatures were accordingly placed
upon the jugular vein and the carotid
artery at point close to the collar
bone and the vessels were divided.
A big machine by which artificial
respiration can be maintained for a
length of time was then brought to the
side of the operating table to be ready
for instant use, and then, with touch
of his knife, the surgeon divided the
pneumogastric nerve.
The patients breathing stopped at
once.
To all intents and purposes Fellows
died at thai instant. There was a tiny
hutter of the pulse, but it stopped in
stantly. No movement of the heart
could be perceived and there was no
involuntary attempt to resume res
piration.
Instantly the tubes CT the artificial
respiration machine were connected
with the lungs of the patient and the
regular painting of the machine sound
ed through the operating thealter. At
the same time an electric battery was
brought to bear on the heart, stimu-
latIng it to regular contractions
Apparently unmoved by these occur
rences Mr. Collier continued his op-
erative work. The growth was dis
sected away from its adhesions to the
tissues and was then lift
ed from its place. 1t brought with it
fully three inches of the carotid artery
and the jugular vein, as well as a large
piece from the side of the nerve.
Then an even more daring piece of
work was done Mr. Collier
knew that the nerve, as it was, would
be altogether insufficient for its work,
even when healing should have taken
place. One of his assistants, therefore.
at once chloroformed a large, healthy
dog, which had been kept for such an
emergency, and, while the animal was
removed a part of its
pneumogastric nerve.
This piece of nerve was then handed
to Mr.. Collier and he carefully approx
mated it to the damaged nerve in Eel
lows neck and fastened it in place. AS
the repair was made Fellows began to
breathe of his own accord and the ar
tiicial breathing apparatus was re-
moved. The remainder of the opera
ton was simple. At its close the
patient was much collapsed, but he
soon rallied. Fellows's recovery was
and he rapidly improved in
general condition. For some time
there was paralysis of a branch of the
nerve which runs to the eyelid. The
puzzle as to how Fellows managed to
maintain the circulation of his body
without the left carotid and jugular IS
solved by the surgeon, who says that
the veins of the other side automati-
cally enlarge themselves so as to take
care of the new duties forced upon
thin by such an operation.-New York
Journal