Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . (Vol. I, page 411). The previous dissec-tions make this ligation easy. The wounds are closed and covered with a tern- TREATMENT OF INJURIES AND DISEASES OF THE HEAD 295 porary dressing. If it is determined to operate upon both sides, the patientshead is then turned and the same operation repeated on the other side (seepage 248). If it is intended to remove the tongue without operating on thelymphatics of both sides, the ligation of the lingual artery of the second
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . (Vol. I, page 411). The previous dissec-tions make this ligation easy. The wounds are closed and covered with a tern- TREATMENT OF INJURIES AND DISEASES OF THE HEAD 295 porary dressing. If it is determined to operate upon both sides, the patientshead is then turned and the same operation repeated on the other side (seepage 248). If it is intended to remove the tongue without operating on thelymphatics of both sides, the ligation of the lingual artery of the second sideremains to be done (Vol. I, page 411). Both Unguals having been tied, the anesthetic may be continued through anasal tube inhaler. The gag is inserted in the mouth on the side least affected,and attention to its security given over to the anesthetists assistant. A silkthread is passed through the tip of the tongue and another posterior to theplace of division to control the stump. The use of the cheek retractor will give still more room. The tongue isdrawn forward. With strong curved scissors the tongue is then cut out,. Fig. 992.—Removal of Carcinomatous Lymphatics of with connective tissue of neck have been dissected up; a pad of gauze protects the wound from cancer cells. the cut being made well back of the disease. The ligation of the twolingual arteries causes the bleeding to be but slight. Sponges in holdersquickly take up the blood; and, if the patients head is turned to one side,blood should not flow back to the pharynx (Fig. 993). After removing the tongue, the dorsal mucous membrane of the stumpshould be sewed to the mucous membrane of the floor of the mouth, providedthis can be done without making so much forward traction upon the epiglot-tis as to prevent its closing the glottis. In some cases the stump may beheld forward by suturing it laterally to the wound in the mouth. If the rawsurface of the stump is not covered by suturing mucous membra
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