Case of wound of internal carotid artery successfully ligatured / by William Keith.

  • Keith, William, 1802 or 1803-1871.
Date:
1851
Catalogue details

Licence: Public Domain Mark

Credit: Case of wound of internal carotid artery successfully ligatured / by William Keith. Source: Wellcome Collection.

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    her u sowens ” with perfect freedom, expressing her entire convic¬ tion that the pin was gone. 9 p.m.—Throat feels raw. Complains of debility. Bowels moved by enema. 26th.—Egg allowed to breakfast and soup to dinner. Bowels moved naturally. 27th.—Removed the remaining stitch and all the plasters from the wound in the neck, and found it firmly united from end to end. One drop only of moisture, and that a surface ooze, seen at the inferior angle of the wound. No moisture or redness around the ligature, which comes out at and behind the angle of the jaw. 28th December.—Bowels three times opened, stools mucous and faintly tinged with blood. Pricking pains felt occasionally in right side of belly. 29th December.—A large consistent stool followed the administra¬ tion of a dose of castor oil. Is quite easy since. The pin searched for, but not found. 30th December.—Going on well. Easy in every respect. Appetite good; bowels easily regulated; wound whole; requiring no dress¬ ing. The ligature retains its hold of the vessel. In consequence of this fact, though up and going about, she was detained in the hospital. 10th February 1851.—The report is,—On trying the ligature, it came away easily—this being the fifty-second day since the vessel was secured. 17th February.—She was dismissed cured. She continues well up to this date,—8th March 1851. The case is brought forward, chiefly as a duty to the profession,—to put on re¬ cord a casualty, and that of a very grave nature, occurring in the midst of what might be deemed a trifling act of surgical manipula¬ tion—to show how it must be met should the like happen again, and to show that, in some circumstances, a single ligature may suffice to stop hemorrhage from the internal carotid artery when wounded. While recording this case—all successful as it has been—I should ill discharge my self-imposed task, if I did not accompany it by the expression of my strongest conviction, that such a case must be excep¬ tional. Early impressed by the writings of John, and the lectures of Sir Charles, Bell, with the absolute necessity of tying both ends of a wounded artery, it has ever been with me a downlaid axiom; and my wonder has often been excited by the alleged backwardness of surgeons to see and act upon it. Deeply grateful ought the profession to be to the talented Guthrie, for so ably, graphically, convincingly, pressing on us this vital rule. It is surely admitted and adopted more generally than he imagines, for reason and common sense should settle the whole question, with any possessed of a tyro’s knowledge of anatomy and physiology. In the case recorded, a double ligature was passed under the vessel, the object in view being, if the hemorrhage should not cease after