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Show IH'i 1 I s The Cut in Chin and Throat The SmnllcrCuts -with Drains ji; Which Would Have' Been IfWK NSv Which Would Have Saved ( . Ncce8ary to Bare the Gland sj$js'J Guby's Life at an Earlier ' , for Operation at the Last VtntJa ' Stage of tho Infection. I I . feago of Her Illness. wflVKeasS J 'I . ,"" ' The Dcep-Seated Lymphatic Glands of tho ' T- ". Neck Which Were Involved in the Infcc- '.; -ci ' '; ; . 1. - ' , tion Following Gaby's Case of Influenza. v ' , ' tN a. parlor of Gaby Deslys's luxurious Paris home a ' . . I half dozen of the most eminent physicians and sur- .' ,f geons in France were gathered in solemn council. They were discussing ways and means of saving the ( . - life of the celebrated stage beauty who lay In a room beyond, worn, weak and wasted by months of painful - illness. H : At last a decision was reached another operation m" must be performed at once! But this time the siir- 3. -L- geon's knives, which had already penetrated the Inside jli of her throat nine times, must be applied from the out- . side. Through the soft, lovely flesh of her neck tho j.J : " . blades must cut their way in one last heroic effort to I . ' root out the deadly infection which was slowly but I I surely killing her. Through this operation, the medi- jl . cal experts agreed, lay the only hope of saving her .... life, j; " - .Mile. Deslys's personal physician left tho others ' f . and went to her bedside. As gently as he could he I told the patient of what had been decided. But the j t - r actress did not wait for him to finish. She interrupted y with an eager question the very question which those j f -vTvho knew her best might have been sure she would ,isk. i The great physician hesitated it was a r question ji' he would rather have left unanswered but profes- siona'i honor compelled him to tell the truth. Yes, the i, knives would cut deeply; the marks they left would be ' Ineradicable; she would undoubtedly carry the scars 1 . to her grave. ', . . With a flash of her old-lime vitality Gaby Deslys h , , . raised her still charming head from the pillow and j ";-) stretched out her thin arms in vigorous protest. Her voice, for days hardly raised above a hoarso whisper,'. rang through the r,oom with surprising shrillness. 1 . "Mais non!" she cried. "But no I Scar my lovely ;y neck? I'd rather die." . ;;' In vain her physician, tho nurses, her dearest friends vand relatives, pleaded nothing could shako her determination. Tho chance of life held no lure for her as long as it involved the loss of the beauty -,'' to which she had given a lifetime of pride and painstaking pains-taking care. Aud so Gaby Deslys died a self sacrifice to vain pride of beauty. Science was helpless nothing i: could do was capable of overcoming the handicap imposed im-posed by her refusal to have her neck scarred. Had It not been her neck and throat on which disease- laid its destroying finger very probably Gaby Deslys would to-day be well, on the road to health. ; But those were features of her beauty in -which she t took especial delight". In her estimation nothing could J enhance their charms not even the marvelous pearls & which wpre given her by King Manuel of Portugal and Ipjf which were tho only gems sho - jKfci deemed worthy to encircle a throat so fair. The mere thought that life - $1$ could be won. as Dr. Arthur C. ' .lacobson explains on this page, -' only .by cruelly scarring iho " Jv;v-, . most treasured loveliness of : ' ''s-.-i'' if!! her beautiful body made ..even 4 ' igf death lose its terrors for Gaby Jra$?k, ' Deslys. Certainly no greater sacrifice was ever offered on JeS? the altar of woman's vanity. - , $0$ 1 .' ' By Arthur C. , Jacobson, M. D. U ijj'.. 4 Associate Edjtor of the Medical Times. - j i j j CABLEGRAM from Paris the other B j - ( day brought the news of the death f '. i ' of Gaby Deslys, tho famous stage j j beauty, at the age of thirty-six, ns the re- i'y suit of a surgical affection following an j 'ji attack of influenza. j( Gaby Deslys Avas In New York only last ji,' October on her third visit to this country. 11 For some reason she returned hastily to ; , France, and shortly afer arriving there Hj s she was sti'icksn with infiuenza. Her con- H dition became grave in December and sho III 1 died last month after having bravely un- II 1 dergone nine surgical operations. ' 1 Had she been willing to undergo a still III i, w more serious operation it is probable that H lit her life could have been saved. But Gaby HI kj Deslys prized her good looks more than HI i; v ' life itself, and she stubbornly refused to consent to an operation which would have Hi - necessitated the permanent scarring of her i '. lovely neck and throat. Her life was sac- j rificed for the sako of her beauty. I j J Tbo famous stage star made a game j " fight for life. Two of the nine operations which she underwent were performed j without, the administration ot a general j! k anaesthetic, but when an operation from ji the outside of the neck became necessary j I in order to save her. the. surgeons' efforts j I were blocked by her insistence that the ji ' soft, delicate beauty ot her neck be not Ijf I , marred even in the slightest degree. B 'j? , The immediate cause of Gaby Deslys'3 BIh untimely death was empyema'. This is a ' pus-forming condition of the pleura, the B j i' r serous membrane which covers the. lungs B jr and is reflected therefrom as the inner B i ilninj or the chest wall. But empyema was B it only the last ot several serious troubles fl whiQh resulted from the streptococcic In- U fectiou that followed Gaby's attack of in- B J j, tluenza. B in: There are certain germs that flourish B !!' in the mouth, Avhich under ordinary con- B 111 ' dltions of health do no harm, but which 1 L after sudden and severe Infections, par- fl jS ticularly influenza, gain admittance to the B 11! body with ease and in great numbers, and BHIu 1 themselves set up secondary or "mixed" B ( . ! infections which may completely over- JJJ; . , shadow the original disease. When the B ' resisting forces of the body are weakened ( Jn tllis way potentially virulent organisms Blt: are cnalj,ed to multiplj In numbers and B ji, ', increase in harmful capacity. H T, Probably the most important of the IU potentially virulent germs of this class is B , the Streptococcus pyogenes, a pus-produc- B ( ing organism. In tho presence of Influenza Wljjin tnis organism frequently gathers virulence (ft much more rapidly than the others, and B i fl' ,3 tnc cause of many of the most grievous B H complications of the disease. At times It 1 i': even outclasses the pneumococcus, another fl Ijj;-' common mouth organism, in causing pneu- B fi monia. fl j The streptococcus figures largely in dis- B 1 1 11. cases that are associated "with or follow B 1 1 I infiuenza, such as pneumonia, meningitis, B I P empyema, septjlcemia, pericarditis, endocar- B'! ditis, peritonitis, middle-ear abscess, mas- jjt't! toiditis, brain abscess, sinus disease, in- B fection of the Jugular and other veins, ton- Billlr ' silltls, erysipelas, arthritis, bone abscess, B j!M i kidney absces3, abscess of the thyroid and I Hi i cellulitis. B UrV Streptococci are parasitic disease-pro- B ji I , duclng organisms, not known apart from' human and animal hostsi They seem , to occur not infrequently in health, upon the' surface of the body, in Its various openings, open-ings, and In the alimentary canal. Such organisms are to be regarded in all case? as potentially virulent and disease producing. They are the primary infecting in-fecting agents in - many in- fiammatory. pus-forming and J$ blood-poisoning disturbances. 3&jL Barson points out that they ' are secondary agents of im-portanee im-portanee in all pathological conditions of the throat of f 'ij&lM whatever nature. Hektoen found them to b'e the most W$i frequent complicating organ- W&wfa isms in scarlet fever, and f)ltmM Councilman showed that they are the most frequently complicating organisms In M&ftKg small-pox. flrffir! Streptococci are spherical dm in shape, of variable size, and are constantly associated in pairs or in chains of from four to twenty Pr nwc individuals. There are few differences f ween tho throat appearances produced Dy streptococci strepto-cocci and diphtheria organisms and the only positive method of differentiating the one from the other is bv means of a careful bacteriological examination. Such r.n examination should always be made, as it has muci weight in connection with the treatment. Dr. Flexner, of the Rockefeller Institute, in a large series of autopsies, found many o! the bodies invaded by numerous strep- -tococcl, causing what he has called "terminal" "term-inal" infection, and hastening the fatal issue. A goodly proportion of these were cases of chronic heart or kldnev disease. Since IS'Jo considerable attention has been bestowed upon antistreptococcic serum, which is said to act specifically upon streptococcus infections, both general gen-eral and local. Numerous cases of suppuration, sup-puration, septic infection, childbed fever and scarlet fever are upon record in which the serum seems to have exerted a beneficial action. But this subject. is still debatable. The serum is prepared by the injection of cultures of living virulent streptococci into horses until a high degree of immunity immun-ity is attained. It is believed both to antagonize an-tagonize the toxins of the streptococci and to be fatal to the life of the organisms themselves. What happeue'd in the case of Ill-fated Gaby Deslys was probably this. She contracted con-tracted influenza and the consequent lowering low-ering of her bodily resistance permitted the development of a streptococcic tonsillitis.- The adjacent tissues of the throat .were then invaded by the infective agent and Ihis was followed by an involvement of the glands In tho neck (adenitis). Then pus-forming and Inflammation began In other neck structures (cellulitis). The streptococci organisms gained access to the blood, causing bacteremia, septicemia, pyemia, and, finally, there was an invasion of the pleura, causing the condition known as empyema. The formation of abscesses in the throat and subjacent structures necessitated tho series of operations to which the actress was subjected in the vain effort to save her llfo. It is plainly to bo in-inl in-inl from Gaby's insistence in-sistence that her neck be not scarred that the pus - forming process had extended into the glands of the neck and subcutaneous structures. struc-tures. This should have been attacked from tho outside and would have necessitated numerous inelsinna ind ennrn ' ' A Photograph, of Gaby Deslys Showing the Throat and gP'-PSi Bos-om of Whose Beauty Sho Was So Proud That 7 ' Death Seemed to Ker Better Than Disnfjuration. - WIS -degree of scarring. Sucu a procedure might have saved her life had it been performed per-formed before empyema set in, shortly before be-fore her death. It appears that the empyema em-pyema an accumulation of pus in the cavity cav-ity of the pleura was detected by tho X-ray X-ray and tho diagnosis confirmed by exploratory ex-ploratory puncture. Tho danger of scarring that might havo marred Gaby's beautiful neck had sho submitted sub-mitted to a radical operation on the part of the surgeons is made clear by what Professor Warbasse has to say on the subject sub-ject in his work on "Surgical Treatment." Writing of cellulitis and abscess of the neck, ho remarks that free incision into the infected area is the one and imperative impera-tive thing to be done. It cannot be put off with palliative or tentative treatment. It Is urgent because of the dangers of deop inflammation of tho connective tissues ot the neck. He advises that an indurated -area in the neck should be exposed by incision if it Is associated with symptoms of Infection. The surgeon should not wait for swelling (Cj 1020, Intcrnattocol Fcatuto Service, Inc. v' " -u ' -., ,; " ' 0 BP v 14 : science. Killed mi' -,0Mt?-M . Sfc, A Famous Wmm0 fM:':y - " im m j or redness of the skin, as may be done in other parts ,of tho body. The incision should not be made blindly, but should bo a dissection down to the centre o'f the' Infection. It may be made In front of tho sternomastoid muscle (which passes from behind the ear to the breast-bone and collar-bone), behind it or through it. Having reached the infected area, continues con-tinues Professor Warbasse, the dissection should be continued downward to secure drainage ot its lowest limit This is Important, Im-portant, even though the operation be carried car-ried to the breast-bone or collar-bone. Pus may not be discovered, and, the operation i3' more timely and effective' if It is not. A continuous skin incisiou need not be made, the lower opening being independent. indepen-dent. The essential hopelessness of the situation situa-tion in Gaby Deslys's .case is readily apparent ap-parent in-view of the n)auner in which sho hampered the surgeons In their conduct ot the' caso by her stubborn refusal to allow her neck to be scarred bv their knives, and in view of the overwhelming Great Britain Bight Reserved. 1 A "Vanity Picture" of Gaby Worshipping- Herself Her-self in Her Mirror. combination of septic factors after the invasion in-vasion pf the pleura. Gaby Desly3's mode of life, of long duration, dura-tion, was by no means calculated to enhance en-hance ner powers of resistance against disease dis-ease of the character which flnallv killed I0?? ID faCt-' aSainst. any disease of more than passing moment. The great stage favorito was Indeed a "Gabrlelle of the Lillies, as her stage name signified, and not an organism of sturdv growth This was why she fell a comparatively SKllS? fSi 10 sPtococcl whoaS activities followed her attack of influenza, f J |
