File:The principles and practice of surgery (1916) (14764195495).jpg

Identifier: principlespracti1916warr (find matches)
Title: The principles and practice of surgery
Year: 1916 (1910s)
Authors: Warren, Richard, 1876-
Subjects: Surgery Surgery
Publisher: Philadelphia : Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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magnified). nests is important, as there is considerable resemblance, and while wide removal is often indicatedfor cancer, this course will end disastrously if practised for tuberculousulceration. The careful examination of the lungs and sputum for evidenceof tubercle, night-sweats, anaemia, and wasting will point out the conditionwhile the ulcer is yet small. In doubtful cases, before commencing alarge operation for removal of the tonsil and glands a froz n sectionshould be taken of the ulcer, as the diagnosis of tubercle from cancer iseasy under the microscope. Treatment. In most instances painting with lactic acid, and powderingwith orthoform, as palliatives, are as much as can be done but whore thecondition of the lung is uol severe local removal may be undertaken frominside the mouth, and this practically means enucleation of the tonsil. Syphilis OF THE Opal PHARYNX. Primary infection is rare, and usuallyaffects the tonsil ; diagnosis may be difficult from cancer or tuberculosis.
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ll> A TEXTBOOK OF SURGERt From tubercle the absence of signs of anaemia in the Lungs, and tubercle bacilliin the sputum, will help to Beparate; while Erom cancer the early greatenlargement of the glands while the ulcer is quite superficial and the sur-rounding oedema, as well as a positive serum reaction, should distinguish. Secondary lesions are common on the soft palate, tonsils and pharynx,taking I he Eoi m of mucous patches or, as they are Bometimes called; snail-track ulcers. thoughulceration is not present till later: ihegrey,shiny snail-t racks a re formed of patches of thickened, sodden undesqua mated epithelium. In the tertiary stage gummata are common and very destructive, ulcera-ting rapidly, perforating the palate; if multiple a large pari of the palate may melt away and he lost. Where the pharyngeal wall is affectedas well the palate may become adherent to this and Mock the air-wayfrom the nasopharynx, while contraction of the pharynx leads to difficultieswith deglutit

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