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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    found firm and strong. The lung was adherent to the thoracic wall, but during the manipulations these adhesions were partially torn. An incision was made into the lung substance for about one-third of an inch in depth. Hemorrhage was very profuse for a few minutes, but steadily lessened. The incision was packed with a roll of sublimate cotton, and from that time there was no further bleeding. The edges of the wound were drawn loosely together and a roll of cotton placed at the exit. The dog had no fever, and continued well On the third day it was found that he had removed the plug, but no hemorrhage followed, and he remained in good condition. A pair of forceps, which were carried into the wound to search for the plug, drew out a large clot. It was not offensive, but its removal was followed by a free hemorrhage for a few minutes. The dog was killed at the end of the fourth week. The wound had entirely healed, and he had never been sick or lost his appetite since the second day. The lung was found closely adherent everywhere about the wound, with firm cicatrices of the lung substance where it had been incised. There was no sign of pus anywhere. The pleura was smooth and perfectly healthy, and there was no effusion. There was only the ordinary amount of normal serum, and no roughness or lymph. The membrane was smooth and glistening, and there was no inflammatory trouble in the lung tissue around the site of the operation. Experiment II. Suturing of lung; adhesion of pleural surfaces ; second- ary pneumonotomy, followed hy septic infection from accidental rupture of adhesions.—A black and white spaniel, of moderate size, was etherized, shaved, and cleansed. Incision was made between the seventh and eighth ribs on the left side, and the intercostal muscles laid bare. Without opening the thorax, a chromicized catgut ligature was carried through the muscles, then through the lung, by a handled, sharply-curved needle. Two sutures were inserted. The wound was closed antiseptically with silk sutures, and dressed with iodoform and collodion. The dog rallied in about five minutes. The animal was in good condition, and did fairly well until the tenth day, when the wound was re-opened. The pleura was found adherent with con- siderable firmness to the lung at the line of suture between the seventh and eighth ribs. An incision was made into the substance of the lung. Bleeding was slight, and was arrested by simply packing the wound. Some of the adhesions were accidentally broken down, which permitted the entrance of air into the cavity, and probably of some drops of pus from the granulating surface. The wound was freshened, sutured, and closed. Purulent infection, however, from the opening into the pleural cavity spread and induced septic pleurisy, from which the dog died on the second day following. The serous cavity contained a large amount of fetid pus, and the lung had collapsed. The adhesions around the site of operation had, of course, entirely given away under the suppurative process. The wound had not closed.