Experiments in pneumonectomy and pneumonotomy / by De Forest Willard.

  • Willard, De Forest, 1846-1910.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Experiments in pneumonectomy and pneumonotomy / by De Forest Willard. 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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    9 becomes necessary in order to secure adhesion and a direct com- munication with the outer world, which route should be walled in so thoroughly that the tubercular material cannot infiltrate either the pleural cavity or the general system. The following experiments were performed to test the possibility of the production primarily of such adhesion, and also to determine the tolerance of the lung to secondary incision into its tissue. One of the plans adopted was to drag the lung into the chest incision and secure it firmly in situ, causing it thus to form a firm plug at the opening, which plug should become firmly adherent around the circumference. By this method free escape of the dis- eased product could be primarily secured while the pleural cavity would be shut off. Another method consisted in lightly suturing the opposing pleural surfaces, in order to produce an adhesive inflammation. These experiments are too few in number to give a positive result, but, taken in connection with my experiments in bronchotomy through the chest-wall [Amer. Journ. Med. Sci., December, 1891; Trans. Amer. Surg. Assoc., 1891), they show the existence in the dog of a remarkable tolerance to lung interference. Experiment Id Primary suturing of lung; secondary jpneumonotomy; recovery.—A small-sized Scotch terrier, male, was etherized, shaved, and scrubbed with sublimate solution. An incision was made on the left side between the fifth and sixth ribs. There was no hemorrhage when the pectorals and intercostals were divided. There was partial collapse when the pleural cavity was opened ; ether was then suspended. The lower lobe of the lung was caught with blunt haemostatic forceps, drawn to the opening, and sutured to the circumference with chromicized catgut. There was no bleeding from the muscular tissues, and but little from the needle-holes in the lung. The wound was sutured with silk, cleansed with sublimate solu- tion, and dressed with iodoform and collodion. The dog was in bad con- dition and breathing rapidly, but he walked about in ten minutes. On the following day the dog was perfectly well, and apparently had suf- fered nothing from the wound. On the ninth day the stitches had given way, and the wound was accordingly opened. It presented a granulating surface covered with healthy pus. The pectoral muscle, which had united, was torn through with the finger. The adhesions around the opening were 1 For most helpful assistance in thesfe experiments I am indebted to Drs. Joseph