Grover Cleveland: Secret Jaw Operations - The First Operation

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THE FIRST OPERATION.

Commodore Benedict and Secretary Lamont remained on deck during the operation, which was performed in the cabin. The steward was the only other person present, to fetch and carry. I have always thought that due credit was not given to him, and to the captain and the crew, for their never betraying what had taken place. It is curious also that the alert and ubiquitous reporters seem never to have thought of interviewing the captain and crew of the Oneida. The captain and crew knew Mr. Cleveland very well, for he had already traveled over fifty thousand miles on the yacht and his mere presence was no novelty. Any curiosity as to the evidently unusual occurrences was apparently allayed by the statement that the President had to have two very badly ulcerated teeth removed and that fresh, pure air, and disinfected quarters and skilled doctors, all had to be provided, lest blood poisoning should set in -- a very serious matter when the patient was the just-inaugurated President of the United States.

Doctor Hasbrouck first extracted the two left upper bicuspid teeth under nitrous oxid. Doctor Bryant then made the necessary incisions in the roof of the mouth, also under nitrous oxid.

At one-fourteen P. M. ether was given by Doctor O'Reilly. During the entire operation Doctor Janeway kept close watch upon the patient's pulse and general condition. Doctor Bryant performed the operation, assisted by myself and Doctor Erdmann.

The entire left upper jaw was removed from the first bicuspid tooth to just beyond the last molar, and nearly up to the middle line. The floor of the orbit -- the cavity in the skull containing the eyeball -- was not removed, as it had not yet been attacked. A small portion of the soft palate was removed. This extensive operation was decided upon because we found that the antrum -- the large hollow cavity in the upper jaw -- was partly filled by a gelatinous mass, evidently a sarcoma. This diagnosis was later confirmed by Dr. William H. Welch, of the Johns Hopkins Hospital, who had also examined the former specimens.

The entire operation was done within the mouth, without any external incision, by means of a cheek retractor, the most useful instrument I have ever seen for such an operation. This retractor I had brought back with me from Paris in 1866. The retention of the floor of the orbit prevented any displacement of the eyebaIl. This normal appearance of the eye, the normal voice, and especially the absence of any external scar, which was the most important evidence of all, greatly aided in keeping the operation an entire secret.(2)

[The cheek retractor bought in Paris from Luer in 1866 by W. W. Keen. By its means the operation was done wholly within the mouth thus avoiding any external scar.]

Only one blood vessel was tied. Pressure, hot water; and at one point the galvanocautery, checked the bleeding. The hemorrhage was not large, probably about six ounces -- say a tumblerful -- in all. At the close of the operation, at one-fifty-five P. M., the pulse was only eighty. The large cavity was packed with gauze to arrest the subsequent moderate oozing of blood. At two-fifty-five P. M. a hypodermic of one-sixth of a grain of morphin [sic] was given -- the only narcotic administered at any time.

What a sigh of intense relief we surgeons breathed when the patient was once more safe in bed can hardly be imagined!

Mr. Cleveland's temperature after the operation was 100.8 degrees Fahrenheit, and never thereafter rose above 100 degrees. His pulse was usually ninety or a little over. With the packing in the cavity his speech was labored but intelligible, without the packing it was wholly unintelligible, resembling the worst imaginable case of cleft palate. Had this not been so admirably remedied by Doctor Gibson, secrecy later would have been out of the question.

In turn with the others, I sat by Mr. Cleveland's bedside much of the time that evening and the next day, reading to him at times to help pass the time. Doctor Bryant's and my own full notes say nothing about any stimulant. They would have recorded the stimulant if any had been administered. My recollection, also, is clear that none was given. Our notes do not record the exact day when Mr. Cleveland was able to get out of bed, but my recollection is that it was late on July second. That he was up and about on July third is certain, for I saw in Commodore Benedict's guest register on the Oneida the signatures of the President, Secretary Lamont and Doctor Bryant on July third, two days after this very serious operatlon.

Doctor Hasbrouck had been landed at London on July second. I left the yacht at Sag Harbor early on July fourth and came directly home. On July fifth, in the evening, the yacht reached Gray Gables and "the President walked from the launch to his residence with but little apparent effort."

For the events after July fifth the extracts from Mr. O'Brien's statements (p. 4) give all the needful particulars.

Footnote:
(2) This cheek-retractor I have deposited with the College of Physicians of Philadelphia together with the portion of tissue removed and photographs of the casts of the mouth on which Dr. Gibson molded the artificial jaw which he kindly presented to the College.


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