A clinical lecture delivered to the students of surgery in the Royal Infirmary of Edinburgh, at the conclusion of the winter course for 1828, 1829. Edinburgh, February 1829 / [George Ballingall].

  • Ballingall George, 1780-1855.
Date:
[1829]
Catalogue details

Licence: Public Domain Mark

Credit: A clinical lecture delivered to the students of surgery in the Royal Infirmary of Edinburgh, at the conclusion of the winter course for 1828, 1829. Edinburgh, February 1829 / [George Ballingall]. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    which the above practice is advantageous, and those in which it is not only injurious, but absolutely insufferable. Before quitting this subject I would beg leave to mention that there are two points in the treatment of compound fractures upon which my own observation has led me to form a very decided opinion, and to offer you a remark which may possibly prove useful hereafter. I have, I think, too frequently seen a reluctance to use the saw in removing the protruding extremities of the bone, when these were either difficult to reduce, or of a sharp and spicular form ; and I have, I think, sometimes seen the closure of the external wound attempted by means too forcible and too long con- tinued. Amongst the more severe accidents requiring amputation which have occurred during the present course, that of Robert MkGregor, JEt. 15, deserves particular attention. This' lad was admitted late on the evening of the 28th of January, and the following notice of his case entered in the journal: “ Had his right arm drawn into the machinery of a paper mill at 5 P. M. The arm was torn off from the body above the middle of the humerus. The extremity of the bone projected out from the muscles. The laceration extends on the inner side of the arm into the axilla, destroys the inferior margin of the pectoralis major and latissimus dorsi muscles. The skin for a short way on the back of the scapula is destroyed, and also a consi- derable part of the clavicular portion of the deltoid. “ The artery is seen pulsating about three inches from its end, which is closed by coagulated blood. No haemorrhage had taken place ; his extre- mities were cold, and pulse feeble.” The operation at the shoulder joint was performed by Dr. Campbell, who succeeded me in the active duties of the house. A single flap was made from the deltoid, which completely covered the wound ; four vessels were secured, and an opiate administered. The patient had a good night after the operation, and no untoward circumstance occurred until the night between the 1st and 2d of February, when a secondary haemorrhage took place, which is thus noticed in the journal: “ About 10 p. M. there came on a considerable haemorrhage from a small vessel which was tied, and about half-past 2 this morning the liga- ture came away from the axillary artery, and haemorrhage ensued. The vessel was immediately secured ; a considerable quantity of blood was lost. Pulse about 130, stronger than yesterday evening. An anodyne was given. Cont. H. Anodiyn. cum T. Opii. gtt. xxxv.” For several days after this, the patient appeared to be in considerable