. The breast: its anomalies, its diseases, and their treatment . e. Division of the antero-lateral columns of the spinal cordas has been advised and practised by Spiller and Martin (Jour. Amer. Med. Assn., Mayi8, 1912, 58, 1489) for persistent pain in the lower extremities might be tried as a sub-stitution method for division of the cord. We regard both of these procedures as ultraradical, and rarely indicated. Division of the cords or trunks of the brachial plexusmerits consideration and may likewise suggest itself in recurrent involvement of theplexus associated with excruciating pain in the
. The breast: its anomalies, its diseases, and their treatment . e. Division of the antero-lateral columns of the spinal cordas has been advised and practised by Spiller and Martin (Jour. Amer. Med. Assn., Mayi8, 1912, 58, 1489) for persistent pain in the lower extremities might be tried as a sub-stitution method for division of the cord. We regard both of these procedures as ultraradical, and rarely indicated. Division of the cords or trunks of the brachial plexusmerits consideration and may likewise suggest itself in recurrent involvement of theplexus associated with excruciating pain in the absence of edema of the limb. Injections of novocaine or other anesthetic drugs around the plexus (peri-neural)above the clavicle may give relief for a short time. Favorable results, especially the relief of pain have been obtained by has advised the use of radium for edema of the arm complicating breast cancer. Lymphangioplasty and amputation are operations to be considered although theemployment of the latter is rarely if ever Fig. 221.—Latitude of motion of the arm five days after radical amputation of tlie breast. Pnetunonia complicates the post-operative period in a small number of cases. Itoccurs with no greater frequency, however, after radical amputation of the breast thanafter other major operations. The disease, in the majority of cases, is of the catarrhaltype, although the one fatal case of pneumonia following a breast operation which we haveobserved had a frank lobar involvement of the lung on the operated side. The prophy-lactic measures to be employed are similar to those recommended in all cases before theadministration of any anesthetic, viz., careful examination of the respiratory tract, withthe exclusion of cases presenting active inflammatory troubles and pre-operative cleansingof the oral, nasal and pharyngeal cavities. Uremia and other post-operative complica-tions after breast amputations are not more common than after o
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectbreast, bookyear1917
