Operation for Cancer in Aged Persons

1853 Boston Medical and Surgical Journal  
at a late meeting of the Medical Society of London, the following case :-W. M-, aged 68, a tall, wellbuilt, bony man, an agricultural laborer from Essex, had suffered for two years from an epithelial cancer of the hand, which commenced as a warty scale upon the thumb. This had progressed in spite of all treatment, until when he came under my care at the Cancer Hospital, Dec. 3, 1852 ; I found the thumb and forefinger separating by ulcération, and the disease extending across the whole of the
more » ... the whole of the back of the hand. After a few days' ineffectual attempts to stay the immense purulent discharge, I, on the 22d of December, removed the forearm three inches below the elbow-joint without pain or consciousness, the chloroform having acted very kindly. The only circumstance worth remarking in the course of the operation was the tying a large patulous vein. The patient at this time was weak, had a very red, glazed tongue, with a disposition to diarrhoea. For the first week he did well, slept by means of a grain of opium at night, and took milk, wine, and fish. At this time the stump became inflamed, the stitches sloughed out, and the flaps separated. Generous diet, with porter, bark, and acid, soon set up a healthy action, and granulations began to spring up; but it was a month after the operation before the stump had quite healed. I may state as a small point of detail that I found in this case, as in others, that the ceraimti attpuula spi«td mi lint was must serviceable ¡u keeping ill« putts cool and in nice apposition. At the same time that the stump became inflamed, the right leg and foot began to swell, accompanied with considerable tenderness of the calf and along the inner side of the thigh.
doi:10.1056/nejm185306080481905 fatcat:hyq5hljeuzc2rphikhvlz4hdqa