Description of the encircling ligature apparatus ... with an account of the various modes of application, and a summary of the comparative merits of the apparatus. Translated from the German, by Fredrick F. Weiss / [Carl Ferdinand von Graefe].

  • Gräfe, C. F. von (Carl Ferdinand), 1787-1840
Date:
1834
Catalogue details

Licence: Public Domain Mark

Credit: Description of the encircling ligature apparatus ... with an account of the various modes of application, and a summary of the comparative merits of the apparatus. Translated from the German, by Fredrick F. Weiss / [Carl Ferdinand von Graefe]. Source: Wellcome Collection.

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    be made to supersede the use of the screw. This may be the case in many instances, but certainly not under every variety of circum¬ stances : for instance, when it is necessary that the ligature should be gradually and almost imperceptibly tightened, this can be accom¬ plished in a much more satisfactory manner by means of the screw; which, besides being only half the width of the winder, obviates the inconvenience incidental to the wearing of a larger and heavier instrument. These excellent qualities induced Dupuytryen, and other French surgeons, to imitate the mechanism of my apparatus in a variety of ways. At all events, the possession of two windlasses, if attended with no other benefit, would enable the operator to substitute one for the other, should either be in any way injured: there are few cases, however, in which one would not be, in some respects, preferable to the other. 26. (g.) This apparatus is admirably calculated to produce arte¬ rial pressure. The instruments recommended for this purpose by Deschamps, Ayrer, Scarpa, and Bujalski, have each affixed to that end which comes in contact with the artery, a square plate at right angles with the stem. This plate has a hole for the recep¬ tion of the ligature; and projects either on one side only, as in Eckhold’s, or from both sides, as in Deschamps’, &c. The plates are not very small either, some measuring half or three- quarters of an inch long, and a quarter broad ; and their removal from the wound is as painful and difficult as disengaging a barbed hook. Even when the wound is kept open with lint, greatly to the inconvenience of the patient, the soft parts will project over the plate; particularly in the case of a deeply-seated artery. When the ligature is required to remain till the third or fifth day, and the inflammation has subsided, and the process of healing commenced round the stem of the instrument, the liga¬ ture may be easily brought away, but not the instrument. Its removal can only be effected with much painful laceration of the parts, which often causes hemorrhage to a considerable, and sometimes a dangerous, extent. With my ligature-holder,—which is a small tube, perfectly free from any hooked projections, and as round and smooth as a sound,—the wound may be allowed to close; and, although it were to heal all round, the small thin cylinder might be easily removed, without any separation where