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has occurred in Philadelphia—a greater number than has occurred in any other American or European city.
McClellan's last surgical feat was the resection of the upper maxillary bone. The disease was scirrhoma.
He operated June 15th, 1846, assisted by Drs Atlee, Morton, and his son, Dr. J. B. McClellan Two integumental incisions were made; one extending from the left angle of the mouth to the temple, across the zygoma, the other from the inner canthus to a point in the line of the first incision, about half an inch above the angle of the mouth. The two flaps being removed from the tumour and bony processes, the maxillary bone was cut through at the base of the nostril on the left of the vomer, by means of the saw and Liston's bone forceps. Then were made the sections of the nasal process at the inner canthus, the sutural end of the frontal process and the zygomatic process. The soft parts of the eye were subsequently detached from the orbitar process, and the soft from the bony palate. These numerous soft and bony separations having been thus rapidly made, and that without a cowardly and cruel preliminary taking up of carotid and other arterial trunks, McClellan boldly seized immediately with his hand, the whole cancerous mass thus detached by saw, forceps, scalpel and fingers, from nostril, eye and malar bone, and tore it from the remaining attachment to the pterygoid processes of the sphenoid, the deep-seated keystone bone of the skull. All came away without further difficulty. The horrid cavity, after proper inspection of the soft and bony parts, and the tying of a small artery, was stuffed with lint, and the flaps replaced and secured. The patient, though he fainted during the dressing, bore the operation with great fortitude. He has since recovered and is doing well.
