Formation of a Substitute Lower Lip

JAMES SYME
1850 Boston Medical and Surgical Journal  
his bowels became very costive so as to require the administration of very active aperients. In about a week from the date of the occurrence he felt severe pain in the right hypochondrium, about the situation of the pylorus, which became more severe every day, extending up the right side towards the shoulder. Subsequently he had some degree of nausea and vertigo, and complained of a very peculiar distressing sensation, which he described as resembling a sudden and violent raising upwards of the
more » ... sing upwards of the right side of the body, from the point in which he felt the pain to the top of the head. This feeling recurred frequently and distressed him very much. When this state had lasted a few days, he suddenly discharged a large quantity of blood by the bowels, and very soon after a quantity of clotted blood by vomiting. The ordinary remedies were had recourse to, but the hemorrhage continued until the patient expired, about four-and-twenty hours from the first discharge of blood. The apothecary who was in attendance, stated that, immediately after death, he distinctly felt the coin in the part where it was suspeoted to have been impacted, namely, in the pylorus, but an opportunity was denied of testing the correctness of this opinion by a post-mortem examination. Dr. O'Connor considered the novelty of the occurrence of death from such a cause a sufficient reason for bringing the case under the notice of the Society, more particularly as in books there is more generally found a recital of the extraordinary substances that have been swallowed and passed through the alimentary canal without producing much injury, than of the exceptional cases in which death has been produced by swallowing objects apparently less calculated to cause danger.-lb. The operation formerly in use for restoring the lower lip was one of the most unsatisfactory in the practice of surgery-so much so, indeed, that few practitioners felt inclined to try it more than once, if they did so at all. The principle of its performance was to obtain integuments sufficient for the purpose by dissecting a flap from below the chin, and turning it round, so as to occupy the vacant space. The ordinary result of this proceeding was sloughing of the transplanted part, which, in the event of escaping that danger, constituted a most unseemly and un-
doi:10.1056/nejm185009250430809 fatcat:i2kk2lgtgzew7efgnucx2ebrxm