THE PRINCE'S MALADY.

Te Aroha News, Volume V, Issue 238, 21 January 1888, Page 2

THE PRINCE'S MALADY.

<" Le Proqres Medical " of March 27th and . April 10th, 188J, contains an exhaustive article on the subject of excision of the larnyx by M. Baratoux, in which are given reports of 104 cases of this operation, which, with the six 'American cases not included, make 11Q cases in w ich this operation was performed. The present condition of Unser Fritz make 3 the results obtained in these cases of especial interest, as it is not impossible that an' operation oi this nature may be performed on him. The first operation of this nature was performed by Professor Watson of Edinburgh in 1866, but to Billroth of Vienna is due most of the credit for the present known operation. His first case was in 1873. Of all the cases on record, , about 60- per cent, or slightly less, recovered^ and 30-per cent, "were permanently' relieved. There are cases in which cancer has not recurred, although ten ,'and * even fifteen years have elapsed since the operation, A well-known physician, spoke of the following American case of excision of the larynx, which he said was more remarkable and successful than that of Dr. Bull's, an account 'of which was printed in' the * f World." The physician said : tl The operator was Dr. Roswell Park, a professor in the University of Buffalo, N. Y. A patient applied to Dr.' Park, October, 1884, and from that timeuntil June, 1885, on his advice, was treated medically by Dr. Henkel of Buffalo for papilloma of the larynx. In June, 1885, h<S was so much worse that tracheotomy had to be performed to save him from suffocation, as the, cancer had filled the whole calibre of the organ, s The patient had a full realisation of his affliction. No other measure than total excision offered any hope of recovery or permanent relief. In favour, of this operation the excellent physical condition and powers of, endurance of the patient spoke highly, as well as the fact that there was no tumour outside of the laryngeal box itself. His, case was far worse than that of the Crown Prince n,ow, and about as bad as his will be in six months. The only argument against the operation was the known danger of the measure, :which was riot afdetor of much importance when it was considered beside the 'fact that the disease, if left to itself, must result fatally in a short time. - The patient determined on the' operation and took a private room in the Buffalo General Hospital June 28, 1885. The complete excision of the larynx was performed.. Dr. Phelps, 1 One of the surgeonsnow on duty at Chambers r street Hospital, in this cityi gave the chloroform. It was necessary > to make an incision in the middle line of the neck along from just above the point commonly known rfs " Adam's apple h down to, the tracheotomy incision which had previously been, made. This cut was about six inches long, Careful dissection was then mdde down on either side of the larynx and trachea, the muscular' attachments were peeled off and- the separation of the soft parts on either side was carried as high, as the hyoid bone (at the base of the tongue) and as low as the second rin£ of the treachea —the windpipe. The windpipo^nd* nipper tracheal ring were now rapidly" separated from the oesophagus, and, 1 after this pepara- ; tion ,was complete from below, the con- j structors were dissected off above and, the whole larynx was then removed in ' one piece. The operation was performed with the utmost caie in an hour's time. The bleeding was considerable, but easily controlled by, proper measures.' The tracheotomy tube was left in its place in the trachea be-; low and tho cavity from which the larynx had been removed was packed with iodofprm. *The. patient rallied after the operation and from the second i day- was fed by* means of a, stomach tube passing, mto < the oesophagus through 'the wo;und. In five weeks he was wearing 1 the lower part of the silver artificial laVynx which was 1 constructed for him after, u the model of Professor Gussebauer. A week later the \ipper part; of the- artificial larynx, 1 connecting the lower j>art with 'his throat and" air passage, was put in place, and he .breathed through his "nose once uiore* and was, able; to whisper loud enough to tie heard across the room.' jflnseven w.eeks'he was able to swalknv soft solids* when the obturator 6fthe;upper tijbe was introduced., Jn eight weeks he was able, by means, of the vibrat"ing reed inserted in tKe'tiibeyto speak .with perfect distinctness. Since then he has . had, perfect health, ond no recurrence of' ( cancer seems threatened. > . I