Title: Text-book of operative surgery
Year: 1903 (1900s)
Authors: Kocher, Theodor, 1841-1917 Stiles, Harold J
Subjects: Surgery, Operative Surgery
Publisher: London : Adam and Charles Black
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library
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sure on the trachea. 6. Where the tumour is malignant with marked infiltration and enlargement ofthe glands, where there are signs of thrombosis, and where the general condition of 1 This suspicion is always present in the case of an elderly person, or indeed in that of any oneabove thirty in whom the thyroid begins to enlarge without obvious external reason. ANTERIOR TRIANGLE OE THE NECK 35 the patient is deteriorating, in which cases we have had better resulte with theadministration of arsenic. 7. Where the goitre is inflamed, tin, inflammation involving the capsule and thestructures adjacent to it. Removal of the thyroid in an acute inflammatory conditionexposes the patient to the danger of a spreading wound infection ; and it the goitre isin a state of chronic inflammation, its removal is often attended with severe hemor-rhage and shock, the result of difficulties connected with the adhesions. In those numerous cases where the above dangers (which are chiefly due to undue <?j~S
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I Fig. 54.—Symmetrical transverse curved incision (collar incision) for excision of the thyroid glandthe incision follows the line of cleavage of the skin of the neck, hence a tine cicatrix is obtained. delay in operation) do not exist, we aim at a rapid, sure, and successful cure byoperation under the following conditions :— 1. By avoiding all antiseptics, both in preparing the patient and during theoperation, and by using the strictest aseptic precautions. 2. By substituting cocaine for a general anaesthetic. Xervous and sensitivepatients with healthy lungs and heart may be anaesthetised with a mixture of air andether (Brauns method) without hesitation. 3. By using a large incision properly placed. We recommend our symmetrical collar incision as shown in Fig. 54. This incision leaves a scar which is hardlyperceptible; moreover, it gives plenty of room, and it has the great advantage ofenabling one to determine, in doubtful cases, which lobe is causing the greater amountof compre
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Tagged: , bookid:textbookofoperat1903koch , bookyear:1903 , bookdecade:1900 , bookcentury:1900 , bookauthor:Kocher__Theodor__1841_1917 , bookauthor:Stiles__Harold_J , booksubject:Surgery__Operative , booksubject:Surgery , bookpublisher:London___Adam_and_Charles_Black , bookcontributor:Yale_University__Cushing_Whitney_Medical_Library , booksponsor:Open_Knowledge_Commons_and_Yale_University__Cushing_Whitney_Medical_Library , bookleafnumber:166 , bookcollection:medicalheritagelibrary , bookcollection:cushingwhitneymedicallibrary , bookcollection:americana