A report on the operations for fissures of the palatine vault / by Thomas D. Mütter.

  • Mütter, Thomas D. (Thomas Dent), 1811-1859.
Date:
1843
Catalogue details

Licence: Public Domain Mark

Credit: A report on the operations for fissures of the palatine vault / by Thomas D. Mütter. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    lor tightening the knots; the surgeon's fingers being all that is required. After the first knot is made, the surgeon passes his forefingers out towards the cheeks, and this tightens the ligature previously wrapped around each ; the assistant then may seize the knot in a pair of common straight forceps, and hold it firmly until the second be tied. Both ends of the ligature are then cut off close, so as to prevent their irritat- ing the fauces, and causing cough. Caution must be ob- served in this part of the operation, not to tie them too tightly, lest they produce ulceration, or cut oat. Age.—Surgeons, with but few exceptions, have come to the conclusion, that the operation should never be attempted until the individual is old enough to appreciate its difficulties and dangers, as well as the the benefits likely to ensue from it when success attends our efforts. It is hardly safe to un- dertake it before the sixteenth or eighteenth year. Health.—The state of the general health should always be taken into account before the operation is decided upon. If the patient be feverish or too much debilitated, troubled with a cough or sore throat, or enlarged tonsils, or suffering from derangement of any of the important chylopoietic viscera, nothing should be attempted until these difficulties are re- moved. It is supposed by some that fluor albus, chronic ulcers, and strumous inflammations, from their debilitating influence by which the adhesive process is materially inter- fered with, particularly contraindicate the performance of an operation the success of which so essentially depends upon the speedy union of the surfaces in apposition. Season.—Although the operation may be performed at any season of the year, yet, when we have it in our power to select the period, we should always decide upon that least liable to atmospheric vicissitudes. Mid-winter or late spring probably answer best. When the weather is very warm the patient bears confinement badly, and there is of course more risk of inflammation. In early spring or autumn the changes are so rapid, and occasionally so severe as to cause colds and