Wednesday, March 11, 2015

Dr. Jacob Solis-Cohen and Tracheotomy in the Civil War

Excerpted from: Jill's Soapbox/History of Trachs

In 1860, Abraham Lincoln was elected President of the United States on an anti-slavery platform. Within three months seven Southern states, led by South Carolina, seceded from the Union. These states formed the Confederate States of America, plunging the country into the Civil War. Virginia's loyalties were with the South, but in May 1861 Alexandria was invaded by federal troops and was occupied for the duration of the war. The city became the base for the invasion of Union troops into Richmond, Virginia, the Confederate capital.

The Civil War claimed the lives of six hundred thousand Americans, both white and black. The suffering of the wounded was eased by ether anesthesia, discovered in 1842 by Dr. Crawford Long. Amputation was the most common surgical procedure of the war and was considered the best way to save the lives of soldiers with bullet wounds in an extremity. Other common medical procedures included bullet extraction, ligation (sewing of an artery to stop bleeding), trephine (drilling a hole in the skull to relieve the pressure of a hemorrhage), and the administration of opium or morphine to kill pain. It was at this time that Dr. Jacob Solis-Cohen (1838-1927) championed laryngology in America.

Dr. Solis-Cohen, considered a founding father of the specialty, completed his medical education at the University of Pennsylvania in 1860. He served in the Civil War as a surgeon from 1861 to 1864. Throughout his career, Dr. Solis-Cohen developed lifesaving surgical techniques for the management of illness and disease associated with the air and food passages. One such technique he developed was the complete removal of the larynx (voice box), called a total laryngectomy. This procedure is most often performed to treat a well-established cancer of the vocal cords and associated organs.

Without a larynx, breathing through the mouth and nose or speaking normally is impossible. Dr. Solis-Cohen's technique for total laryngectomy allowed patients to develop speech utilizing the esophagus. His procedure also permitted the patient to breathe through a tracheotomy that did not require a tube. Tracheotomy is a surgical practice calling for cutting into the front of the neck, making an opening in the trachea (windpipe) and usually inserting a silver tube to act as the new airway.


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