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Show 01- ItlL blt'tbit/h' 01'- 'I'HL Flight" UM LINGUELN or THE TUMOUR ON THE TONGUE. it shall be contracted; then to substitute a small tube, which he does not cut into the substance of the tongue, so as to touch the ranine arteries. £30 being introduced from the mouth, shall also pass some way into that part of the duct, which discharges the saliva. Lastly, while the tube is retained in its place, the outward lips of the wound are to be made raw, brought together, and healed. But the circumstances of the case may be such, that it will be better to make a new duct, from the fistulous opening into the mouth. To do this, we must push a straight needle, obliquely from the bottom of the fistula, into the 21 ULCER KND TUMOUR ON THE TONGUE. mouth, and draw through a small seaton, which is to be THERE occurs very frequently on the tongue, an ulcer, with a foul eineritious coloured bottom. ‘We have to exa» 'mine whether it may not have arisen in consequence of its being incessantly torn, and irritated by a spoiled and rag~ ged tooth; in which case the tooth must be drawn, or tiled down and smoothed. But chiefly we must be careful to ob worn until the passage is callous. Then either with or serve the connection with the stomach, for I believe this to without introducing the tube, we have to endeavour to be a frequent cause of this ulcer. This will readily be believed, when we consider the intimate sympathy betwixt the unite the edges of the outward opening. tongue, and stomach, made apparent to us on many occa- DlVlblON OI" THE FRENUM LIKGUIE. THEM: are few surgeons who have not cut the freenulum iingum. Notwithstanding this, I venture to say that it is never absolutely necessary. There may be an expediency, than in. .. ‘ rd-W-r"? "LP -1- "Mag-r.- f. «(1.. ‘, ,-.. ._ . . .s when the surgeon has not weight enough with the mother to convince her that her child cannot be prevented from sucking from this cause. Sucking is effected chiefly by the motion of the lower jaw; and the tacking of the tongue even forward to the gums, will not prevent the motion necessary to sucking. I doubt even whether this tying of the tongue, will impede the speech. But at the age, which has such a motive for the operation, I have less objection to it. In infancy, the consequences have been well ascertained to be suffocation from swallowing the tongue, and death from sucking, and swallowing the blood during sleep. To do this, or any other little operation under the tongue, an assistant having the child on his knee, puts his fingers in~ to each side of the mouth, and under the tongue so that he pushes it up. With blunt pointed scissors, the surgeon cats the membraneous part of the frzrnum, taking care to . ' avoid 1‘ n Iv: a»... H' *L "raw V011? and that in the motion of the child, sions; as by the state of the secretion of the tongue, lnflu-t enced by the healthy and diseased action of the stomach. When neither medicine, nor diet, have influence on the ulcer of the tongue; when it becomes painful, and the edges rise and are ragged, the ulcer may be cut out, after which the tongue quickly heals. To do this the common tenaculum is introduced into the substance of the tongue, so as to pass under the ulcer. Then with a common scalpel, run along the convexity of the tenaculum, the diseased part together with the instrument is cut out. The tongue may be out very freely, but let the operator be aware of the situation of the ranine arteries. "7hen, however, the disease of the tongue is deep, when excrescences with deep roots grow upon it, or when there are small, firm tumours, formed in its substance, we adopt the means suggested to us by Mr. Homes/F. Having well examined the depth, and utmost. extent of the disease, a crooked needle (drawn to the middle of the li- gature) is passed through the substance of the tongue, beyond the diseased part, the middle of the ligature being cut, ‘ See his Observations on Cancers |
