The practice of surgery . es only upon the deep cervicalmuscles. Sew up the wound carefully, and leave a cigaret drain at itslowest angle. Rapid healing is promoted by supporting firmly the neckfor a w^eek in a Thomas collar or some similar device. Let me say to the practitioner that I am aware some surgeons doubtthe wisdom of this wide operation, but abundant experience of myown and the still wider experience of Crile and others have convinced methat nothing short of this gives reliable promise of permanent cure ingrave cases of extensive cancer of the lip and neck. It seems almostneedless to
The practice of surgery . es only upon the deep cervicalmuscles. Sew up the wound carefully, and leave a cigaret drain at itslowest angle. Rapid healing is promoted by supporting firmly the neckfor a w^eek in a Thomas collar or some similar device. Let me say to the practitioner that I am aware some surgeons doubtthe wisdom of this wide operation, but abundant experience of myown and the still wider experience of Crile and others have convinced methat nothing short of this gives reliable promise of permanent cure ingrave cases of extensive cancer of the lip and neck. It seems almostneedless to say that involvement of both sides of the neck with massivetumors, that profound cachexia, and the suspicion of distant metastasescontraindicate positively any operation whatever. Another form of cancer of the face is that curious and unique processwhich we call rodent ulcer. RODENT ULCER This is a cancer originating in the sebaceous glands. The diseasemay arise anywhere on the face—especially on the nose, eyelids, and. Fio;. .367.—Rodent ulcer. cheeks. Its first manifestation is a little knob about the size of a splitpea, harmless and little noticed. The knob may remain for years, when INJURIES OF THE FACE 555 suddenly, without obvious reason, it begins to ulcerate and to progress,destroying all the superficial parts in its neighborhood—skin, muscles,fat, cartilage, eyeball, and bone—producing a horrible grows unceasingly; it is painless; it gives rise to no metastases; itappears as a raw, sloughing, indolent ulcer. Its origin is in the sebaceousglands, as I have said, and the little original nodule is seen microscopicallyto consist of gland-ducts filled with epithelium. For years surgeons treated rodent ulcer by the cautery and by ex-cision, followed b}^ extensive plastic operations. Of late we have cometo believe that when exposed to radium, the disease is aborted rapidly,and the ulcer heals without leaving a scar} There are sundry other injuries an
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
