Another case of amputation of the thigh at its upper fourth, in which acupressure was successfully employed : with remarks / by P.D. Handyside.

  • Handyside, P. D. (Peter David), 1808-1881.
Date:
[1862]
Catalogue details

Licence: Public Domain Mark

Credit: Another case of amputation of the thigh at its upper fourth, in which acupressure was successfully employed : with remarks / by P.D. Handyside. 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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    s fatal effect of excessive hajmorrhage by transfusing the blood of another individual into the veins of the patient. 1th, The cases of amputation generally^ in whicli acupressure has been employed, range, I am informed, from thirty to forty in num- bc • f which I hope soon to be able to present a summary that iSm,^ prepare the way perhaps for a cautious induction. These include at least six cases of amputation through the thigh.^ Stii, It is interesting to observe, first, how very slight is the amount of acupressm-e that is necessary ^ in order to closp a bleed- ing vessel; secondly, for how short a time pressure need be main- tained ^ in order to produce that eflfect; and, thirdly, how acupres- sure has not been productive hitherto of any unpleasant symptom, or ev^-^ of any appreciable effect on the adjacent veins or nerves. In applying acupressure is there no risk of producing injm-ious pressm'e on adjoining parts ?—is a question that has been asked. In the foregoing narrative it was stated that the artery of the sciatic nerve had been directly compressed; now here was suffi- cient compression to arrest haemorrhage from the centre probably of the nerve, and yet no injurious pressure was exerted upon the deli- cate nerve tissue. The patient has remained indeed to this day free from any such symptom. But it has been suggested that the great pain in the back that was felt on the day after the operation was due probably to compression of the great sciatic nerve by the long needle employed to control its central artery. It seems clear, however, that this lumbar pain experienced by the patient after the operation depended simply on cold and exposure on the operating table (or, as he himself expressed it, to cold and the hard bed on which he lay on his back ); for, while removal of the long needle did not lessen the pain he endured, which became more severe to- wards night, and was relieved once and again by the use of a com- mon strengthening plaster, applied at his own suggestion (a remedy which, while resident at Sunderland, he had had recourse to for cold), it gradually disappeared from his feeble and exhausted habit under a fi-eer use of wine, an animal diet, and a tonic draught. 1 See a notice of five of these cases in the Journal of Pract. Med. for Nov. 18G0, English edition, p. 481. . , t^j. n,T r i 2 See Professor Simpson's remarks on this subject m the Edm. Med. Journal for Jan. 1860, p. 645; the Dubl. Hosp. Gaz. for Jan. 2, 1860, p. 7; and the Med. Times and Gaz. for Feb. 11, 1860, p. 137. , • , ,r 3 Illustrative of this remark is the following extract from Malgaigne s Man. de mdi. Operat., 6th edit., Paris, 1853, p. ProcecU de focA.—Aprds toutes les amputations, I'op^rateur ramene le lambeau sur la plaie, et le mam- tient par les bandelettes agglutinatives. Une compresse longuette est iix6e sur le traiet de I'artere, a I'aide d'lme simple bande. On donne ou moignou ime position un peu (51ev^e, et un aide exerce avec la main sur le moignou une douce m-ession continuee pendant une ou deux heui-es, et memo aussi longtenips Su'on yressent des pulsations consid^-ables. Quand elles out cess6, et que l\ppareil est teint en^ouge par la lymphe qui a sumt^, f'''^ VwTo'^srtS danger d'h6morrhagie cons6cutive a d.sparu, pourvu que le '^^^ ^/^^J^^^^^^^^^ quiUc De semblables promesses n'dtaient pas de nature seduire bcaucoup les chirurgiens, et ce proc^d^ est justeraent abandoim6. Edinburgh, 11 Hope Street. Ibth Feh-uary 1862.