A clinical lecture delivered to the students of surgery in the Royal Infirmary of Edinburgh, at the conclusion of the winter course for 1827-28. Edinburgh, March 1828 / [George Ballingall].

  • Ballingall George, 1780-1855.
Date:
[1828]
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 1827-28. Edinburgh, March 1828 / [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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    the knot being tied, one end of the ligature was cut off, and the wound dressed with adhesive strap. On the following morning the patient, after a restless night, was found complaining of tenderness over the surface of the abdomen, increased upon pressure, his pulse 116; his bowels confined, his skin hot, and thirst ur- gent. The limb had for some hours after the operation felt cold and be- numbed, but was now nearly of the natural temperature ; no pulsation being perceptible in any part of it. Leeches were ordered to the surface of the abdomen ; the patient’s bowels were directed to be relieved by an injection ; the limb to be kept enveloped in warm flannel, and an opiate to be again exhibited at bed- time. In a few days, the abdominal pain and tenderness had completely sub- sided under the use of mild laxatives and fomentations ; the patient’s general health and spirits continued tolerably good, with the exception of some slight rigors and tendency to sweating ; his pulse, for ten days sub- sequent to the operation, ranging from 90 to 110; and on the eleventh day the ligature separated ; at which time a considerable portion of the wound made in the operation had united, and the oedema of the affected limb was considerably diminished, but it was still subject to a considerable degree of numbness, and no pulsation to be felt in any part of it. On the 30th of January, the wound made in the operation for the ligature of the artery was almost completely cicatrized, and the patient requested leave to get up, to which I consented ; and while putting on his clothes haemorrhage occurred from the wound, but ceased on the application of dry lint; at 4 o’clock of the same day the bleeding recurred, and was checked by a piece of sponge. On the 31st, two slight bleedings occurred previous to the visit, and about one o’clock of that day a haemorrhage took place, by which the pa- tient lost in all upwards of two pounds of blood, apparently from a branch of the obturator artery, the ulceration having latterly extended down to- wards the foramen thyroideum. After this attack, the patient had nausea and vomiting, his pulse becoming extremely weak and fluttering. This bleeding was suppressed by thrusting down a piece of dry sponge into the bottom of the ulcer, and confining it by pressure with the hand. At three o’clock, the patient was still so weak as not to admit of any other step being taken ; a consultation was held the same evening after the clinical lecture, when it was decided that in a case so unfavourable there was no encouragement and no sufficient reason to undertake any far- ther operation, particularly as the haemorrhage was for the time completely