Manual of Surgery Volume First: General Surgery. Sixth Edition.Thomson, Alexis
Science
Manual of Surgery Volume First: General Surgery. Sixth Edition.
Thomson, Alexis
Surgery
In order to prevent recurrence, a tube of _radium_, to which a silk
thread is attached, is inserted into the space from which the tumour was
removed; the thread is brought out at the drain-opening, and at the end
of a week or ten days the tube of radium is removed by pulling on the
thread. Radium causes a reaction in the tissues attended with exudation
from the vessels, for the escape of which provision must be made. If
radium is not available, the affected area is repeatedly exposed to the
action of the _X-rays_ as soon as the wound has healed. The employment
of these measures has diminished to a remarkable degree the recurrence
of sarcoma after operation.
It will readily be understood that the less thoroughly or radically the
growth has been removed, the more do we depend upon radium or the X-rays
for bringing about a permanent cure, and that in advanced cases of
sarcoma and in cases in which, on account of their anatomical situation,
removal by operation is necessarily incomplete, the prospect of cure is
still more dependent on the use of radium or of the X-rays. Finally,
there are cases in which removal by operation is impossible, the
so-called _inoperable sarcoma_; a tube of radium, to which a silk thread
is attached, is inserted into the substance of the tumour, either
through an opening made by a large trocar, or, when necessary, by open
dissection. A second tube of radium is placed upon the skin over the
tumour and is secured there by a stitch or by a strip of plaster, thus
securing a cross-fire action of the radium rays, both from within and
without, as this is found to be much more efficacious in destroying or
inhibiting the cellular elements of the growth. The tubes of radium are
left _in situ_ for from eight to fourteen days, according to the power
of the radium employed, but are moved about every second day or so in
order that every part of the tumour may be efficiently radiated. If the
tumour shrinks in size after the use of radium and becomes operable, it
should be removed before time is given it to resume its growth. It will
depend upon the subsequent course of the disease, whether or not a
second, or it may be even a third, application of radium will be
required.
Where neither radium nor X-rays is available or applicable, recourse may
be had to the injection of Coley's fluid, a preparation containing the
mixed toxins of the streptococcus of erysipelas and the bacillus
prodigiosus; or of selenium.
EPITHELIAL TUMOURS
An excessive and erratic growth of epithelium is the essential and
distinguishing feature of these tumours. The innocent forms are the
papilloma and the adenoma; the malignant, the carcinoma or cancer.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account