Caustic Surgery

A young woman with a slot in her neck --running from the right tonsil inside almost to the notch of her collarbone outside--came to Surgeon Elliott Carr Cutler. This was while he was in Cleveland last year, before he returned to Boston to succeed his old master, Surgeon Harvey Gushing at Harvard. Dr. Cutler cured the girl's cervical fistula by flushing it with a caustic fluid. He thus saved himself a laborious operation, the girl an ugly scar. The clean result, reproduced in other fistulous cases with similar sclerosing fluids, warranted reporting in the current American Journal of Surgery.

The caustic which Dr. Cutler prefers is a "modified Carnoy's solution": absolute alcohol 6 c. c., chloroform 3 c. c., glacial acetic acid i c.c., ferric chloride 1 gm. The solution practically "tans" tissues it comes in contact with. Dr. Cutler uses it to toughen cysts which he must scoop out of brains.

Using the brain-toughener on the fistulous young woman was a "hunch" the immediate success of which amazed Dr. Cutler and his young associate, Dr. Robert Milton Zollinger. Protecting her throat from the caustic effects of the fluid, they merely flushed out the fistula. The flushing burned the lining of the fistula. As the walls healed they grew together, closing the abnormal passage in the neck.

Drs. Cutler & Zollinger used the caustic solution on several other cervical fistulae. They also found the caustic useful in the cure of pilonidal sinus (cavity under the skin wherein grows hair). They open the sinus with a scalpel, then douse the hole with the solution. Thereafter it is easy to ream out the destroyed tissue. The patient need not be bedridden.

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