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ART. XII.???Exsection of the Trunk of the Second Branch of the Fifth Pair of Nerves, beyond the Ganglion of Meckel, for Severe Neuralgia of the Face

1858; Elsevier BV; Volume: 69; Issue: 1 Linguagem: Inglês

10.1097/00000441-185801000-00012

1538-2990

J. M. Carnochan,

Facial Nerve Paralysis Treatment and Research

134 Carnoehan, Exsection of Second Branch of Fifth Pair of Nerves.[Jan.Simpson's sound we measure to the fraction of an inch its depth and degree of flexure.Then, and not till then, are we ready for the Uterine Elevator, taking care to adjust the stem best adapted to the case.The stem is set at the required angle with the shaft, and thus passed into the retroverted uterus b, with the ball close up to the os tincae; then, by pulling back the slide g, the rod a is drawn out of the perforation in the ball, when it is free to revolve in the direction opposite to that of the motor power.Thus by depressing the handle and pushing the ball up towards the promontory of the sacrum, the uterus becomes further retroverted, but by pushing it gently and firmly downwards and backwards into the vaginal cul de sac d, the inevitable result is to revolve the stem with the uterus b, directly upwards, as shown by the dotted lines ee.The uterus may be arrested at any point of this evolution, merely by letting go the slide that holds the rod; or, the movement may be continued till it is completely anteverted, while the weight of the organ will be sustained mainly by the cervix resting on the ball.There are three stems which screw into the ball, one 2 inches, one 2|, and the other 3 inches long, but the medium size is the one ordinarily used.Whenever the long or the short one may be needed, the previous use of Simpson's sound will indicate it.The instrument may be made of silver, of copper silvered, or of German sil¬ ver.I prefer the first two, because the stem often requires a little flexure to adapt it to acute uterine curvatures, particularly where there is much carti¬ laginous degeneration of tissue.German silver is not soft enough for this purpose.1After the malposition is rectified, it will, of course, require some mechanical contrivance to keep it so : whether Meigs' ring, or Hodge's instrument, or some of its various modifications, or Simpson's intra-uterine stem, will depend upon the peculiarities of the case, and the tact and judgment of the operator.Art.XII.-Exsection of the Trunlc of the Second Branch of the Fifth Pair of Nerves, beyond the Ganglion of Mechel, for Severe Neuralgia of the Face : with Three Oases.