Observations on Italian medical institutions and practice : with a brief comparative sketch of some points of French and English practice, and remarks on Italian climate / by Edwin Lee.

  • Lee, Edwin, -1870.
Date:
1831
Catalogue details

Licence: Public Domain Mark

Credit: Observations on Italian medical institutions and practice : with a brief comparative sketch of some points of French and English practice, and remarks on Italian climate / by Edwin Lee. 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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    condition than those with whom the practice of filling the scrotum with charpie (which is not unfrequently attended with a dangerous degree of irritation,) is folIoAved. The occur- rence of subsequent hemorrhage might indeed be a good rea- son for not attemping union after this operation, were not care taken to prevent its happening, by placing a fine ligature on each of the small bleeding vessels of the scrotum. The union of the wound after the ligature of a vessel for aneurism, is considered by M. Rou:: as another abuse of the practice: he says, if such a wound be united with the view of obtaining a speedy cure, it will be necessary to apply no more ligatures than what are absolutely necessary to inter- cept the passage of the blood; the application of supernume- rary ligatures for the prevention of hemorrhage, should it afterwards come on, is incompatible with the immediate union of the wound; at least it would be in the highest degree ridiculous to combine these two things; but to renounce the supernumerary ligatures for the purpose of remedying consecutive hemorrhage, is to deprive ourselves of the most simple remedy in case such an accident should occur; it is sacrificing an important resource to the poor advantage of a speedy cure; it is compromising the success of the ope- ration.* It would appear from the above passage, that, at the time of M. Roux's visit to England, a principle on which arteries are tied in this country, viz. that of detaching the artery as little as possible from its surrounding connexions, discarding all ligatures of reserve, and thereby greatly lessening the chances of consecutive hemorrhage, was not known in France: in fact, the principles which guide our operations on arteries are far from being generally understood on the continent at the present day. Secondary hemorrhage is of much rarer oc- currence after operations for aneurism, ever since a single round ligature has been used, and in those cases where it has occurred, the cause could generally be traced to a diseased state of the coats of the vessel, to the artery having been too much separated from its connexions, and consequently de- prived of the supply of blood necessary for its support; or to the ligature having been placed immediately below the origin of a large branch, thereby preventing the formation of a suf- ficiently firm coagulum within the vessel. M. Roux acknowledges the advantages of the English practice in the treatment of ulcers of the legs by adhesive plaster and bandage, and has adopted it at La Charitc; * Parallble dc Chirurgic, &c.