Ligature of the left common iliac artery : being the second operation in Ireland, and the first successful case of it / by William Hargrave.

  • Hargrave, William, active 1865.
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: Ligature of the left common iliac artery : being the second operation in Ireland, and the first successful case of it / by William Hargrave. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    the limb; oedema lessening; the extensor tendons on the dorsum of the foot well defined; nocturnal rest good, but assisted by the ano- dyne. 20th May, twenty-first day from the operation : Ligature firm and fixed upon the artery; countenance cheeriul; pulse 88, full, round, and bounding. 21st May, twenty-second day after the operationLigature ap- parently protruding from the wound ; at ten p.m., the pulsation returned more evident than at any time since the ninth day after the operation ; still neither bruit nor vibratory thrill in it. From this date nothing much worthy of note was observed, except the intermission in the pulsation, almost always best marked in the vicinity to Poupart’s ligament; co. pil. rhei occasionally required to regulate the bowels. 28th May, twenty-ninth day after the operation : I was much gra- tified by being able to bring away the ligature ; not a drop of blood appeared; it was as strong and sound as the day it was applied ; the arterial loop would admit but an ordinary small sized probe. This fact proved the success of the operation on the artery. From this period all apprehension as to secondary hemorrhage was removed, and the report on the thirty-first day after the operation states, scarcely any discharge from the wound, which gapes much at the in- ferior part of it, owing to the action of the abdominal muscles drawing the internal edge to the mesial line, which was in part prevented by appropriate dressing. On readjusting the flannel roller and cotton wadding on the limb, the external edge of the foot, and the integuments in relation to the little toe and corresponding half of the metatarsal bone presented a deep ecchymosed appearance, and was perfectly cold, which he did not perceive ; the oedema gone except a little pufliness about the external ankle, and the limb much atrophied. This appearance too plainly announced that the powers of the circula- tion were unable to maintain the vitality of these parts ; he was ordered bark and ammonia, phosphate of iron in pill, and port wine substituted for the claret to meet his desire. From June 3rd to the 9th, forty- first day, he was gaining power over the entire of the extremity, feeling it as strong as he ever did ; but anomalous symptoms occasionally were present, as neuralgia of the rectum, allayed by opiate suppositories, occa-