The treatment of haemorrhage from the posterior-tibial artery in the upper two-thirds of its course / by William Harrison Cripps.

  • Cripps, Harrison (William Harrison), 1850-1923.
Date:
[1875]
Catalogue details

Licence: Public Domain Mark

Credit: The treatment of haemorrhage from the posterior-tibial artery in the upper two-thirds of its course / by William Harrison Cripps. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Dupuytren and Syme had sufficient faith in the operation to put it in practice, and if in their time the proceeding was successful, its condemnation as futile by modern surgeons seems to require support by very cogent reasons. Direct pressure in case of fracture is hardly possible, but if the femoral artery cannot be controlled by digital pressure, its ligature seems to promise a fair chance of success. If amputation become eventually necessary, the previous ligature will not materially de- crease the chance of recovery. In the case of secondary hsemorrhage occurring in the practice of Lawrence, that surgeon acknowledged the uselessness of any further attempt to find the vessel in the wound, and considered the only alternative to be amputation, and at once removed the limb^ Dupuytren, on the other hand, in a similar case of secondary hmmorrhage, ligatured the femoral artery with complete succese, remarking at the time that he had saved the patient from the “ cruel mutilation ” of amputation which his colleagues wished to perform. Billroth, in his letters from the seat of war, draws a graphic picture of the difficulties, and in some cases the impossibility, of tying a vessel in a granulating wound. He concludes by saying, that in most of such cases, after much loss of blood has been in- curred in the attempt, the main artery has after all to be tied. Beck and Stromeyer also congratulate themselves on the successful result of ligature of the main vessel. Reference might also be made to S. Cooper’s case, occurring after the battle of Waterloo ; and also to an exceedingly interesting and instructive case published at length in the ‘Lancet’ of 1849, vol. i. p. 614, by Mr Massey of Nottingham. In both of these cases the femoral was successfully tied, in the one case for haemor- rhage from the popliteal, in the other, from the anterior tibial. These cases have been excluded from the Appendix, as- not affect- ing the posterior tibial. {d) Pressure and bandaging. The value of this method of treatment for haemorrhage is in direct proportion to the danger and liability to failure consequent on the inaccessibility of the wounded vessel, or the special con- ditions under which the operation has to be performed. Such treatment would appear particularly applicable in many cases of wound to the posterior tibial. It is not pretended that treatment by pressure is possible in every case of a wound of this vessel, nor should it be anticipated that success will invariably follow even in cases favourable for its trial; but, without doubt, in the majority of instances such treat- ment deserves a fair and thorough trial, and no operative proceeding