Clinical report [on cases in the Edinburgh Surgical Hospital] for the summer session 1835 / [James Syme].

  • Syme, James, 1799-1870
Date:
[1835]
Catalogue details

Licence: Public Domain Mark

Credit: Clinical report [on cases in the Edinburgh Surgical Hospital] for the summer session 1835 / [James Syme]. Source: Wellcome Collection.

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    brow to within a line of the roots of the eyelashes, it was feared that the contraction consequent upon cither excision or ligature would cause eversion of the eyelid; but this seemed a smaller evil than the existing, and still more the aggravated state of the case, which might be expected from the activity of the morbid action, if allowed to proceed unchecked. It was, therefore, re¬ solved to operate, and by ligature, as the part affected was fa¬ vourably situated for this method, while excision appeared likely to occasion troublesome hemorrhage. A strong silk thread was passed through the root of the tu¬ mour so as to divide it into four different portions, each of which was effectually strangled by the ligature surrounding it. No bad symptoms followed. The swelling became black, shrivelled, and fell off on the fifth day. The raw surface healed kindly, and, contrary to expectation, cicatrized without eversion of the eyelid. Neemes resembling a fatty Tumour—Removal by Excision. —Agnes Brown, aged 4 years, was brought to Minto House, on the 19th of August, on account of a tumour seated over the lower part of the back of her neck. It was round and Hat, about two inches in breadth, and having the lobulated shape, as wrell as peculiar consistence, of an adipose growth. The surface was not altered except at the centre, where, for about the extent of a half-crown piece, it was white and depressed. This appear¬ ance resembling a cicatrix was attributed to the effect of inocu¬ lation with vaccine matter, which had been practised twrelve months before. It was stated, that the tumour first attracted attention when the child was nine months of age. I afterwards ascertained that the swelling previous to vaccination had a pur¬ ple colour, and that subsequently there had been a remarkable diminution of size. The tendency to enlargement again re¬ turning, had rendered the tumour larger than ever, and was rapidly increasing it. Not being aware of these latter circum¬ stances at the time, I concluded that the disease depended mere¬ ly upon an adipose tumour, and proposed excision, which was readily acceded to. On making a free incision through the integuments and mor¬ bid growth, I was surprised to see arterial blood springing out in numerous jets, but having then discovered the true nature of the tumour lost no time in completing its removal. So soon as this had been accomplished, the bleeding was restricted to one large vessel, which showed its open mouth on the surface of the fascia. A ligature having been applied, the edges of the wound were stitched together. Union by the first intention did not take place, but the wound healed kindly by granulation. The tumour, though in some parts vascular, was in general quite similar to the ordinary adipose structure, and was deemed such