A case of persistent jaundice of fifty years' standing / W.T. Cocking.

  • Cocking, W. T.
Date:
[1903]
Catalogue details

Licence: In copyright

Credit: A case of persistent jaundice of fifty years' standing / W.T. Cocking. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    portions of the breast. (B) The entire fat, connective tissue and lymphatics of the axilk, together with their prolongation between the pectoral muscles, should be removed in one piece with the breast, so as to render It impossible that lymphatic tissue passing from the breast to tht axillary glands should be left behind. ewhat delicate dissection a keen knife is ork. It is best to commence at the upper xilla. At an early date the axillary vein aid bare and the subsequent dissection it. If rigid asepsis has been observed unnecessary to employ drainage, and In performing this soi indispensable to good and outer edge of the should be deliberately conducted away from during the operation it the first dressing may usually be left undisturbed for a week. When it is found to together excellent results impossible to bring the skin edges nay be obtained by skin grafting, either at the time of operation pr, better still, ten days later. Where the disease is advanced it jnay be necessary to remove the costal portion of the pectoralia major and to divide the pectoralis minor in order to deal thproughly with the upper limits of the axilla. Having regard to the ^extent and position of the wound resulting from the modern operation for the removal of a can- cerous breast, the mortality yttending its performance is gratify- ingly low. In a long serie§^ of cases it would probably not amount to 2 per cent. When a fatality occurs it is most often due to some inflammatory condition of the chest induced by the anaesthetic, or by a wet compre|s improperly applied during the night preceding the operation. ' Inoperable cases of mamm|ry cancer are best treated by giving opium freely. Apart frqm the relief of pain which the drug affords there is good evidence to show that under its influence the growth of the tumpur is retarded. An infusion of fresh violet leaves is said to have remarkable powder in arresting the pain of an ulcerating cancer, and I know of one case—that of an old lady suffering from an ‘^atrophic scirrhus’'—in which it appears to have given great relief. \ Double oophorectomy has been given an extensive trial of late, but there is little evidence to support its claim to recognition as a palliative measure, and still less as a curative agent in inoperable mammary cancer.