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Remarks on an Operation for the Removal of Fungoid Tumour of the Lower JawAuthor(s): Henry CrawfordSource: Provincial Medical and Surgical Journal (1844-1852), Vol. 10, No. 3 (Jan. 21, 1846), p.31Published by: BMJStable URL: http://www.jstor.org/stable/25499038 .
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SOUTH EASTERN BRANCH OF THE ASSOCIATION. 31
Who would dream of allowing inflammation, or
other disorganizing process, to run its course un
checked, for the first few days or weeks of attack,
in any of the organs or tissues of the human frame;
and yet this, the most calamitous if not the most fatal
of the diseases to which suffering humanity is exposed,
is not to be interfered with in its early and curable
stage from the dread of infringement on personal
liberty. Sedulously would we guard this most inva
luable and important privilege by every means in the
power of legislation to devise; but when the precau
tions taken to protect the personal liberty of the doubt
fully insane have a direct tendency to subject a large
proportion of their number to hopeless confinement
for the remainder of their days, then we cannot but see
that legislation has failed in its object, and only
inflicted and perpetuated the very evil which it was
intended to prevent. Those who consult this little work will find many
valuable reflections interspersed throughout its pages in reference to the treatment and moral management:
of the insane. We are unable to follow the author
further, but we cannot conclude without expressing I
an entire approval of the spirit in which his remarks
are written, and recommending his book to the atten
tion of our readers.
COMMITTEE OF THE SOUTH-EASTERN BRANCH OF THE PROVINCIAL MEDICAL I
AND SURGICAL ASSOCIATION.
TO THE EDITOR OF THE PROVINCIAL MEDICAL AND
SURGICAL JOURNAL.
SIR.
Fearing to trespass on your well conducted Journnl, the insertion of a few remarks, having reference td
Mr. Kelson's letter of the 1th instant, if not con.
sidered obtrusive, will suffice.
If I mistake not, Mr. Kelson appears to consider
Medical Reform and the unjust conduct of the Council
of the College of Surgeons, (to which the report
mentioned, when noticing this subject, had almost exclusive reference,) as convertible terms. If so, then
I, as an humble member of the Committee, whose
conduct has been arraigned, willingly bear my part of the "onus" of its report-more willingly, as -I ca assert with truth, that a more judicious, concise, yet
forcible allusion to the unprFedented conduct of the Council of the College of Surgeons, than in ths
official declaration, I have not met with. If they are
not, (as I humbly opine,) then I beg to re-assert" "that
the subject was distinctly referred to the Members
generally of the Branch Association."
My remarks on Medical Reform had reference to
the specific resolutions subsequently proposed, and, as the Journal referred to by Mr. Kelson states, " not
unanimously agreed to."
If I mistake not much, the highly respected gentle man with whom the resolutions originated, merely
wished to submit them to the meeting in bis individual capacity alone.
How far this explanation.will exonerate me from
the charge of being absurdly inconsistent, I must leave
your readers and Mr. Kelson to decide. With respect to his subsequent notice of my remarks, Mr. Kelson's
all-but unique opinions on medical polity, will, I fears
prevent the existence between us of that happy una
nimity, so desirable in every voluntary association.
Wishing Mr. Kelson every possible alleviation in
his multifarious occupations, I am, Sir,
Obediently yours, ROBERT H. POWELL.
Tunbridge Wells, January 14, 1846.
REMARKS ON AN OPERATION FOR THE REMOVAL OF FUNGOID TUMOUR OF THE
LOWER JAW.
TO THE EDITOR OF TIIE PROVINCIAL MEDICAL AND
SURGICAL JOURNAL.
SIR, In the last number of your Journal, a case is reported
of removal of a fungoid tumour of the lower jaw at the
Newcastle Infirmary, and I cannot help dissenting from
the conclusion of the reporter, viz., " that the operation was perfectly justifiable."
Operations for the removal of malignant disease are
unsatisfactory enough, even when the affected parts can be distinctly and entirely removed, but when a
fungoid tumour is " adherent to the jaw," and "the structures below it," I believe there is no sufficient
probability of good result to warrant the undertaking of such a "fearful and hazardous operation' as was
performed in the instance before us, especially as there was "a languid debilitated look, and pale, sallow
complexion," indicating general contamination of the
system. Had the operator persevered in extirpating the whole of the diseased parts, the man would pro
bably have died upon the table; as it is, I should feel
surprised to hear of his being alive six months hence, for so far as my own observation extends, life is seldom
much prolonged by the removal of malignant, (espe
cially fungoid,) disease in its advauced stages. In
many instances a temporary check is given to the
morbid growth, (probably by the loss of blood from the
operation,) but the re-action which ensues, increases
the fatal rapidity with which.the disease passes through its latter stages. I make these observations, not in
the spirit of captious criticism, but with the view of
.sserting as a principle in the science of surgery,-that no operation attended with risk of life should be
attempted, unless there are reasonable grounds whereon
to found an expectation of great and decided benefit, and I am persuaded, that the opinion of our greatest
surgical authorities would have been strongly against an operation in the case reported by Mr. Gibb.
I remain, Sir,
Yours respectfully, HENRY CRAWFORD.
Canterbury, January 8, 1846.
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