Thoracic resection for tumors growing from the bony wall of the chest / F.W. Parham.

  • Parham, Frederick W.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Thoracic resection for tumors growing from the bony wall of the chest / F.W. Parham. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

    18/182 (page 10)
    cut oflf from tlie ril) at about an inch distance from its cartil- age, and the morbid origin of the tumor exposed. The interoostals were now cut throui^di, the diaphragm care- fully separatnl from the rib anil pleura, and a director passed under at the points where the rib was to be divided. The bone was next cut through with the cutting forceps?, and about two inches of it in length removed with a portion of its car- tilage. The diaphragm immediately rose up, forming a hernia between the ribs. The hemorrhage was not great, most of it being from the divided muscles. No artery bled sufficiently to require being secured by ligature. The wound was brought together by sutures and adhesive plasters. The patient was very little exhausted by the operation. A considerable degree of febrile excitement followed, requiring the employment of copious bleeding. The wound was united nearly throughout by first inten- tion, and the patient is rapidly gaining strength without the occurrence of any bad symptoms. In this case, unlike the preceding, very little thickening of the parts lying under the ribs had taken place. This rendered the difficulty much greater in separating the pleura and diaphragm from their adhesions to the ribs, which, how- ever, was finally accomplished without penetrating the chest. (Quenu and Louguet mention resection of the sixth, seventh, eighth, ninth, and tenth ribs.) Both of these operations sufficiently demonstrate that the excision of the ribs, with sufficient precaution, may be prac- tised with comparative safety. Case V. Case of Paget, 1853, chondroma (Paget's Surgical Path- olof/i/). (Case No. 21 in Schh'ipfer von Spoichcr's list.) A man, age not given. The tumor was a pure enchoudroma, formetl of hyaline cartilage. It was removed, but recurred, and death resulted. The second tumor wa-^ mixed in structure, prob- ably medullary Siinoma.