Observations on ligature of arteries on the antiseptic system / by Joseph Lister.

Date:
1869
Catalogue details

Licence: Public Domain Mark

Credit: Observations on ligature of arteries on the antiseptic system / by Joseph Lister. 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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    üf the portion of exteriial coat killecl by tlie tiglitly tied thread; wliile, externally, the constrictiou necessarüy caused in the first instance by the Operation had been filled in by a similar compact structure. Thiis far experieuce had proved precisely in accordance with my expectations, so that I feit justified in carrying a similar practice into human surgery. Gase of ligature of the external iliac artery with silk thread, on the antisejjtic System.—On the 29th of January, 1868, I tied the left external iliac artery in a lady, fifty-one years of age, on account of an aneurism of the upper part of the femoral, as big as a large orange, and reaching somewhat above Poupart's ligament. I was informed that it had existed for four years, growing more rapidly of late, and causing severe agony, which had made her keep entirely to bed for the last few weeks, and had deprived her of appetite and rediiced her strength. A silk thread was ap]3lied, as in the last case, except that it had been steeped for two hours in undiliited liquid carbolic acid instead of the watery Solution, to make sure of the destruction of all septic organisms lodged in its interstices. The wound, being dressed antiseptically, became superficial without suppuration, the patient meanwliile experiencing no febrile disturb- ance, her appetite returniug as soon as the sickness from Chloroform subsided. On the fourteenth day she sat holt upright in bed with- out inconvenience. Four weeks after the Operation, the superficial sore being completely cicatrised, she was allowed to walk about her room ; and just six weeks from the date of the application of the ligature, she went down three flights of stairs and walked for some tinie in the streets, and then up again to her room without over- fatigue. The aneurism was free from pulsation, and much reduced in size. She continued for about ten months in fair liealth and strength; but, in the latter part of November, she became affected with a peculiar spasmodic disorder of the respiration, and on the morning of the 30th of the month, while sitting up in bed, she suddenly exclaimed that something had given way within her, and that she was dying, and then immediately expired. JSText day I made a post- mortem examination, when the idea which she had expressed proved correct—an aneurism of the descending part of the arcli of the aorta liaving given way, and discharged an enormous quantity of blüod into the mediastinal und subpleural cellular tissuc. The parts