Observations on the history of the cure of popliteal aneurism by compression / by the editor.

Date:
[©1846?]
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Licence: Public Domain Mark

Credit: Observations on the history of the cure of popliteal aneurism by compression / by the editor. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    18/35 (page 118)
    *' The remarkable success which of late has attended the treatment of popliteal aneurism by the ' mediate compi-essioii of the femoral artery above tlie sac, entitles this operation to be considered as a means of cure, which, if not universally, is at least generally applicable to such cases. There are cases, however, of external aneurism,—the axillary and carotid, for example,— in which this mode of treatment cannot be employed, for it is well-known that a degree of mediate compression, which would be suflElcient to arrest the current of blood through the sub- clavian artery, could not be endured for ten minutes, and the same is true of the common carotid. I am by no means so certain, how- ever, that immediate compression, if applied to the subclavian artery at the point where it passes over the first rib, and effected in the manner described in the following case, might not be em- ployed with success. A dragoon, about 35 years of age, and apparently of a good constitution, suffered from popliteal aneurism of six months' standing; he was received into the Royal Military Infirmary in the summer of 1830, and, after the usual course of prepara- tion, the artery was tied with a single silk ligature at the usual place, in the presence of Mr. Cusack, Professor Porter, and several other surgeons. Several cases of secondary hjemor- rhage after operations for aneurism having occurred in the course of the year, in consequence of the giving way of the artery at the place of the ligature(a), I determined to try how far such an occurrence might be prevented by drawing the noose of the ligature no tighter than was necessary to arrest the cur- rent of the blood without dividing the inner and middle coats of the artery; the ligatui-e was accordingly closed slowly, while one of the assistants placed his hand on the aneurism. The moment he announced that the pulsation had ceased, the noose was secured by a second knot. The man expressed no pain during the slow closure of the ligature. About an («) See Gimttani cle Wocamaslaus on Aneurismal Surgery, Med-Chiinrg. Trans, vol. vi. p. 350.