Identifier: breastitsanomali00deav (find matches)
Title: The breast: its anomalies, its diseases, and their treatment
Year: 1917 (1910s)
Authors: Deaver, John B. (John Blair), 1855-1931
Subjects: Breast Breast X-rays Breast Diseases Breast Neoplasms Radiotherapy
Publisher: Philadelphia, P. Blakiston's Son & Co
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons

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conductionalong the intercostal nerves is not interrupted. Hohmeier injects novocain-suprareninsolution around and under the breast and along the edge of the latissimus dorsi muscle.This, together with blocking of the brachial plexus, is said to permit of radical amputa-tion of the breast without causing the patient the least degree of pain. Technic of Operation.—The operation for mammary carcinoma performed in thethe German Hospital of Philadelphia is essentially the same as that advised by Halstedin his latest contribution on the subject, except that skin grafting is practically neveremployed, the wound being closed primarily, in the majority of instances. The arm on the affected side is abducted almost to a right angle, and the forearmflexed; this position of the arm and forearm being changed from time to time in thecourse of the dissection. When the axillary vein is exposed and dissected free, thenurse holding the arm, is instructed not to put too much tension on the vessel. To
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Fig. 208.—Line of the axillary artery. have the arm and forearm held and manipulated by an intelligent nurse is much moresatisfactory to the surgeon than to bind the extremity to the table, as is the practice insome hospitals, or to a dissecting board, as advised by Turner. It also prevents anypossibility of injury of the musculo-spiral nerve from pressure. The patients head is covered with a sterile rubber cap reinforced by a sterile towel,and her face is turned to the side opposite the field of operation; the latter is further ex-cluded from the exhalations of the patient and the anesthetist by the disposition of steriletowels. In the absence of an experienced etherizer, the screen or towels should beomitted in order that the operator may be able to observe that the anesthesia is progress-ing satisfactorily. Under all circumstances, the anesthetist is provided with sterilerubber gloves, sterile ether bottle and sterile gauze. Ample protection of the operativefield is afforded by s

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