OCR Text |
Show or run CANCEES or THE LIP. :31: - 25 or run csxchs or run LIP. This disease I believe is not often a true cancer but arises from some accidental irritation, and is kept up by the inces~ accurately together, without puckering, or ruggedness at the lower angle. For example, if the incision of one side should be in a curv- sant motion of the part. And this too I believe to be the ma ed direction, and the other more direct, the effect will be, that. son why the disease is so frequent in the lower lip, and in the angle of the mouth, for the upper lip has least motion. While other remedies have been applied, I have always strongly recommended the use of an adhesive. strap, to retain the lip, as much as possible from motion. And this fixing of the lip, is the advantage gained by poulticing those sores. My attention was drawn to this circumstance, from observing that in very bad cases, some of the slighter ulcerations situated by the side of the greater diseased portion, and which could not be included in the portion cut out, healed while the pins were. in the lip. I naturally conceived this to arise from the per. feet upose of the lip, after the operation. 1 :eed here only state the fact, that venereal ulcers have int-en cut out of the lip, being mistaken for cancers, and that the disease has broke out again, and yielded to mercury, This will be a sufficient caution, to make us examine both the history of the disease, and the concomitant symptoms before are operate. The most frequent beginning of this cancer of the lip, is an irregular warty excrcscenee with a broad base, or an obscure tubercle within the lip. "Then a sore, or disease is spreading, from such a commencement, I would not delay extirpation. The following method I prefer to the common one of using forceps. A flat piece of wood, is shaped to go down betwixt the lip, and the gums, having a rude handle, which the as~‘istant holds, at the same time that he stretches the lip upon me piece of wood, and presses it down upon its edge, so as to prevent the bleeding of the labial artery. Now the surgeon thrusting his tenacnium or hook, into the wood, and meeting so as to make a neat angle below, he cuts out a triangular portion of the lip, including the disease. The nicety, if there be any in this operation, consists in 3‘13"?th the two incisions so that the cut surfaces may come O [Luvs-1'! «:1 -‘l‘t‘fifi‘ 2-9:». I A diseased part, makes an incision on each side, down to the . :4... n.3,"... .Jm._%‘¥ when the parts are brought together, the side with the curved incision is deeper than the other. 1‘ Fig. 1. represents the part cut out. Fig. 2. represents the pins introduced, and the divided lip brought together. The triangular piece being cut away, the assistant witln draws the piece of wood, on which the incisions were made, and holds the two portions of the lip, betwixt his fingers and thumbs. Then bringing them together and applying the surfaces accurately to each other, the surgeon introduces his first needle, about a fifth part of an inch from the surface of the lip, and rather towards the inner part of it; the other (for two are sutficicnt) is introduced in the middle betwixt this and the lower part of the cut. The surgeon should now, put two or three turns of the ligature, about the pins, until the bleeding stops altogether. Then loosening it, he should more accurately wind his thread about the pins, by throwing the middle part of it over the two extremities of the pin, then crossing the ends under the points, so as to form the figure of 8. Having done this with the upper pin, he proceeds in the same way with the lower. If the disease be in the angle, or commissure of the lips, then must there be made two semilunar incisions, terminating in an acute angle on the cheek. VOL. II. n |