Surgical cases and essays / by Rushton Parker.

  • Parker, Rushton, 1847-
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Surgical cases and essays / by Rushton Parker. Source: Wellcome Collection.

    49/136 (page 35)
    On April 27th, under ether, the left subclavian artery was tied above the clavicle with a medium-sized ligature of carbolised catgut; the wound in the integuments being made with a knife, and those in the fasciae with a pointed but blunt steel instrument, aided by dissecting forceps. In this way, after reaching the first fascia, both it and the succeeding layers were easily divided; while the external jugular and other veins were as easily left unwounded and pulled aside. The aperture in each fascia in turn was held open, as soon as made, with two pairs of artery-forceps, by Mr. Bickersteth, who kindly acted as principal assistant. The aneurysm-needle was passed unarmed; then threaded and withdrawn to give place to the ligature. In this way, bleeding was avoided, and accordingly sponging was not required. No incidental obstacles were encountered, and none were created; so the operation was shorn of all difficulty. Lister's arrangements were adopted in the steam-spray and carbolised gauze; the drain being a wisp of horsehair. The dressings were changed on the third, fourth, and tenth days; on the last occasion, boracic lint was used, as a superficial strip of granulations alone remained to be healed. The drain of horsehair had escaped before the third dressing, when it was found convenient to substitute a short piece of tubing. This, having escaped before the fourth dressing, six days later, and, being then obvi- ously no longer of any use, was no longer employed. Pulsation ceased in the aneurysm at the operation, and never re- turned. In the corresponding radial artery, 10 pulse could be detected till after ten days, and then only feebly; and thus it has continued ever since. The limb did not become cold or painful, and no wrappings of any kind were used. The discharge was slight throughout, consisting of bloody serum, followed later by serum ; no pus or lymph. The temperature rose to 102*^ on the evening of the third day, having been 101° on the second, and 99° on that of the operation. It had previously been normal, and subsequently reached 100° on ten successive evenings. But the patient was never ill, or in any way in- convenienced, beyond a feeling of numbness in the limb. After five weeks, he was sent to a convalescent hospital outside the town, and