Surgical lectures and essays / by A. Marmaduke Sheild.

  • Sheild, A. Marmaduke (Arthur Marmaduke)
Date:
[1904?]
Catalogue details

Licence: In copyright

Credit: Surgical lectures and essays / by A. Marmaduke Sheild. Source: Wellcome Collection.

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    end of a tedious proceeding, tlie whole disease seemed to have been removed. There was some difficulty in getting the skin to cover the extensive wound, and lateral incisions were made in several places to relieve tension. The wound was painted over with rather a strong solution of iodoform in collodion, and the axilla packed with iodoform gauze. To this I attribute the unfortunate result which occurred. On the second day the patient became acutely maniacal, and the temperature gradually rose to 104°. The wound, which had been drained, was at once inspected, but it appeared healed. Notwithstanding stimulation, antiseptics, and cool sponging, this patient sank on the fourth day. I regret that the urine was not examined. The leading features of the case were uncontrollable delirium and a high temperature. The examination of the body showed absolutely nothing to account for death. The wound was healed and the cavity filled with firm, plastic lymph. The axillary vein contained a post-mortem clot. There was an entire absence of blood extravasations, mottling, or any of the usual signs of septic action. The lining membrane of the heart and great vessels was not stained. The exami- nation was conducted too long after death for a reliable bacteriological examination of the tissues to be made. Notwithstanding the unfavourable termination of this case, I have thought right to report it, because it illus- trates the important truth that no surgical operation, how- ever generally successful, is quite free from risk. This is the first case I have ever lost after amputation of the mamma. The operation was done with every precaution, the instruments and skin being disinfected with scrupulous care by Dr. Mechod, who assisted me. I much fear that the liberal use of the iodoform emulsion was the cause of the disaster. In connection with this it may be remarked that Mr. Pridgin Teale has experienced just these sym- ptoms in breast cases after the use of iodoform.1 In the year 1894 I injected three drachms of iodoform emulsion 1 Author, ‘ Diseases of the Breast/ p. 427.