A case of right subclavian aneurism of the third portion, cured by the ligation of the first portion and later of the axillary.

Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: A case of right subclavian aneurism of the third portion, cured by the ligation of the first portion and later of the axillary. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    A CASE OF RIGHT SUBCLAVIAN ANEURISM OF THE THIRD PORTION, CURED BY THE LIGATION OF THE FIRST PORTION AND LATER OF THE AXILLARY. This brilliant and unique achievement is reported by Mr. H. H. Glutton, M. C., Surgeon and Lecturer on Surgery at St. Thomas’ Hospital, London, in volume 80 of the Medico-Chirurgi- cal Transactions of 1897. The profession of New Orleans should feel a special interest in aneurism of the third portion of the subclavian artery, because it is in this city that the first announcement was made to the surgical world of a successful case operated in 1864 by Dr. Andrew W. Smyth. It is also here that, for the first and only time, a provisional ligature has been successfully applied, by the lamented Miles in 1893, on the first portion, until the divided ends of the third portion, sectioned by a bullet, were secured. Lastly, it was in the Charity Hospital that the first and only much needed dissection of the collateral circulation of those aneurisms was made by our fellow-towns- man, Dr. Edmond Souchon, on the patient of Dr. Smyth, who had finally succumbed after ten years, to the return of his aneurism. The relation was published in the New Orleans Medical and Surgical Journal. This memorable autopsy showed that after the innominate, the common carotid, the vertebral and the internal mammary had been effectually ligated the return of the aneurism was due to the anastomoses of the intercostals with the branches of the subscapular. These channels of communication were so numer- ous, so large and so direct that Dr. Souchon, in his report of the case, at once concluded that if the axillary had been ligated above the subscapular, the patient would have been cured a second time. This logical view was not accepted by the cele- brated operator, and there this grave question rested for nearly twenty years.