Case of osteo-sarcoma of the lower jaw, in Robert Penman, (aged 24 years,) from Coldstream, who laboured under this most extensive and very painful affection, for upwards of nine years / drawn up and published by J.R. Sibbald.

  • Sibbald, John Robertson.
Date:
1828
Catalogue details

Licence: Public Domain Mark

Credit: Case of osteo-sarcoma of the lower jaw, in Robert Penman, (aged 24 years,) from Coldstream, who laboured under this most extensive and very painful affection, for upwards of nine years / drawn up and published by J.R. Sibbald. 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.

    8/18 (page 10)
    pair of cutting pliers, (these latter, however, may in some cases of diseased structure in bone he injurious, by producing splin- ters, although here they did not.) Professor Ballingall and myself were ready with dry sponges to compress the mouths of divided vessels, and remove blood, until Dr B. took them up, which was done with the coronary artery. I carefully kept my fingers between the divided extremities of the bone, and thus allowed blood to flow away from the mouth. Mr Syme next made a semi-circular incision from the left angle of the mouth, down along the base of the jaw, and upward as high as where the condyle ought or seemed to be, at anterior part of the left ear. During this incision, and while dissecting down this flap from off the tumour and jaw, down to the neck, several small branches of the facial and transverse brandies of the temporal arteries were divided, and instantly secured. Two of these ligatures were afterwards found adhering to the tumour when removed. There being a redundancy of sound skin, Mr S. next made another incision a little curved, and higher up than the former, so as to leave a portion of the cheek, which was much distended, and firmly adhering to the tumour. This upper flap was dissected carefully up the masseter muscle di- vided, and thus exposed the whole surface of the tumour, and now retained principally by the mucous membrane of the mouth ; and which, when divided, allowed the tumour to be moved about in almost any direction. The temporal muscle was now removed, (cut through); the articulation presented no difficulty whatever, having been completely disorganized, both coronoid and condyloid processes being in a manner ob- literated, from tumour having formed encrustations round both processes, and presented a large globular body, more than any thing like the ramus of the jaw, and by cutting closely round the superior point of the tumour, all muscular adhesions were overcome with comparative ease *. This case was by no means analogous to Mr Liston’s, for although greater in extent, and of longer duration, the dis- * Tumour weighed when removed, 4 lbs. 5 oz, and was of a very irre- gular and globular form. Had it not been for sawn extremity of bone, no one could have supposed that it had ever formed part of the jaw.