Schmid consisted in the resection of apes of the lung on one side. On the day before the operation one side of the dog's chest was shaved and thoroughly cleaned, and the animal was operated upon while under the influence of morphia and ether. A portion of the fourth or fifth rib was excised subperiosteally, the portion being made as large and as far from the sternum as possible. A lobe of the lung was now drawn through the opening, or as much of it as possible. This was transfixed with a double catgut thread below the part to be excised, and a part of the lung, including the wedge to be excised, ;was then ligatured. The wedge was excised with scissors, all the larger blood-vessels and bronchi ligatured, and the edges of the lung brought together with catgut sutures. The double catgut ligature round the base of the lobe was now removed, and after seeing that no haemorrhage occurred, the part was returned into the thorax and the external wound closed. Almost no antiseptic precautions were adopted throughout, with the exception of disinfection of instruments, sponges, etc., with salicylic acid. The operation was performed eight times in all, and succeeded in three cases, while in five death occurred. The first dog operated on died within half an hour from carbolic poisoning, the spray having been used ; while the other four died within two to five days from purulent pleurisy, evidently the result of septic infection. There was no haemorrhage or gangrene in these cases, and in only two was there a slight local pneumonia. Several of the animals had subcutaneous emphysema. In no case was there loss of blood from the lungs. Two of the successful operations were on the same animal. Dr. Schmid has performed the same operation, post-mortem, on the healthy and the phthisical human lung. He finds the great difficulty lies in getting thp lung drawn through the opening, more especially when there are extensive adhesions. The operation, he believes, however, is perfectly practicable, and with the choice of suitable cases, and the use of all antiseptic precautions, he considers that the operation is one that can justifiably be attempted on the human body. The results of incision and drainage of phthisical cavities have not as yet proved very encouraging, but it must be admitted that the procedure has not yet had a fair trial. Any advance in the treatment of this terrible malady, before which, in the great majority of cases, we stand so hopeless, and helpless, will be welcomed by us all. Whether such an advance is possible, can be determined only by the skilful diagnosis of the physician, the bold and careful operating of the surgeon.?Medical Times and Gazette,

PARTIAL RESECTION OF THE LUNGS. Abdominal surgery is every day achieving fresh successes, and while ovariotomy remains, and probably will remain, its greatest triumph, the later successes have been neither few So recently as the close of 1879, Professor Nussnor small. " So soon as the baum, of Munich, said in a public lecture, physician diagnoses with certainty a cancer of the pylorus, to the surgeon will allow but little time pass before he excises the cancerous growth." The words seem almost prophetic, have from Dr. Wolfier an a and a half we for within year account of several such operations, some of them successful, performed in the clinic of Professor Billroth. The operation is now recognised, the cases suitable for it described, and the method of performance fully detailed. With regard to abdominal surgery generally, we may say that operations which a very few years since would have been scouted as utterly beyond the pale of rational and justifiable surgery, have been performed with a success which more than justifies the boldness of the operators. The question very naturally suggests itself, how far the thoracic organs lie outside the domain of surgery. The successful treatment by free incision and drainage of pleuritic and pericardiac effusions, whether serous or purulent, is the last advance in this direction ; but in the localized catarrhal pneumonia, the phthisical cavity, and the limited pulmonary tumor, there seems to be a field for further advance, although it is admittedly beset with difficulties of diagnosis for the physician, of technique for the surgeon. As a contribution to the subject, Dr. Schmid, of Berlin, details (Berliner Klin. Woahenschrift, No. 51, 1SS1) the result of certain experiments he has performed These results are put forward in the most on the dog. modest possible manner, with full knowledge of what they do and what they do not prove. The operation performed by Dr.

Partial Resection of the Lungs.

Partial Resection of the Lungs. - PDF Download Free
2MB Sizes 2 Downloads 8 Views