Page:Proceedings of the Royal Society of London Vol 1.djvu/131

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Observations on the Structure of the Tongue ,- illustrated by Cases in which a Portion of that Organ has been removed by Ligalure. By Everard Ho‘me, Esq. F.R.S. Read February 3, 1803. [Phil. Trans. 1803, p. 205.]

These observations will be allowed to have a considerable degree of importance, when we find that they ultimately lead to a safe and effectual method of removing a portion of the tongue, when that organ has assumed a diseased action or morbid excrescences of a cancerous nature, to which this, as well as many other glandular structures, are known to be liable. In a physiological view they will likewise be found to merit particular attention, as they tend to prove that the internal structure of the tongue is not of that delicate and. sensible nature which, from its being the organ of taste, we should be led to imagine.

The first case here mentioned, and from which various inferences are derived which lead to a new mode of treating the disorders of the tongue, was that of a gentleman Whose tongue had been acci- dentally bit near the tip, and had hence become completely insen- sible, insomuch that every article of nourishment he took was equally insipid, and that the tip felt like a bit of wood in his mouth. No de- gree of inflammation, however, or spasmodic tendency having accom- panied these symptoms, Mr. Home inferred that the nerves supplying this, and perhaps the other organs of sense, are not so liable to irri- tation as those which belong to other parts of the body.

Encouraged by this observation, he in three instances performed a new operation upon the tongue, which consisted in removing a portion of that organ by means of ligatures, and. with that portion certain fungous excrescences which might have been productive of fatal consequences. The first patient was a boy eight years of age, who had been born with a small excrescence on the right side of the an- terior part of the tongue. It had been removed no less than eleven times by ligatures round its base, caustics and amputation, but al- ways with considerable and dangerous haemorrhages; and after all without success, the fungus always reappearing soon after the operations. Mr. Home at length resolved to take out the portion of the tongue upon which the fungus grew. This was effected by passing a crooked needle, armed with a double ligature, through the sub- stance of the tongue, somewhat Within the excresoeuce: the needle was drawn out below, leaving the ligatures, one of which was tied very tight before the excresccnce, and the other equally so behind it, so that a segment of the tongue was confined between these two ligatures, in which the circulation was completely stopped. On the fifth day after the operation this portion of the tongue came away with the ligatures, leaving a sloughy surface. which likewise sepa- rated on the fifteenth day. The excavation a few days after this be- came completely cicatrizcd, leaving only a small fissure on that side of the tongue.

The two other Operations were performed on persons above forty