Case of ligature of the common carotid for hæmorrhage from ulceration of the face / by James Spence, Esq., surgeon.

  • Spence, James, 1812-1882.
Date:
[1843]
Catalogue details

Licence: Public Domain Mark

Credit: Case of ligature of the common carotid for hæmorrhage from ulceration of the face / by James Spence, Esq., surgeon. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    Case of Ligature of the (Jommon Carotid for Hoemorrliage from Ulceration of the Face. By James Spence, Esq., Surgeon; one of the Teachers in the School of Anatomy, No. 1 Surgeon Square; Lecturer on Operative Surgery, S^c. (Extracted from the Land, and Edin. Monthly J own. for May 1843.) Bernard Macphee, aged 38, the subject of the present case, had been afflicted, since childhood, with a discharge from the left ear; for several years back there had been a considerable in- crease of pain, the discharge had become more profuse and foetid, and about eighteen months before he applied to me for advice, pain and swelling had commenced on the left side of the face. When I first saw him, in the commencement of March 1842, the whole of the left side of the face, over the parotid and tem- poral regions, and also the upper part of the neck, were greatly- swollen and discoloured. The swelling was hard and tense, but deep-seated fluctuation could be distinguished over the zygoma, whilst the temporal artery was seen pulsating on the surface of the tense swelHng in the temporal region. There was a thin sanious and very foetid discharge from the external meatus of the left ear, and that opening was nearly filled up by a large fungous excrescence. Owing to the swollen and painful state of the face, he had been for some time unable to eat any sohd food. The pain at night was so excessively severe as to prevent him enjoying the slightest repose, and, consequently, his general health had suffered very much. I made a free incision into the swelling over the zygo- matic region, and evacuated a considerable quantity of very foetid pus; this afforded him considerable rehef, and after- wards his general health seemed to improve; this improve- ment, however, was of very short duration, abscesses formed at various points in the parotid and temporal regions, and required to be opened, the zygoma could be felt bare, the discharge was exceedingly foetid, whilst the edges of the incisions were pale, flabby, and everted. He had profuse night sweats, and occasional attacks of diarrhoea, and was evidently becoming weaker every day. In the beginning of April slight arterial bleeding oc- curred from one of the old incisions, but was stopped by compres- sion ; from the situation of the disease, however, I then appre- hended haemorrhage from ulceration of the branches of the internal maxillary artery, or of the superficial temporal, and de- sired the friends to send for me immediately, in the event of any serious haemorrhage recurring; no further bleeding, however, occurred at this period. Shortly after this I advised him to go to the country for the benefit of his general health; and did not see him again till his return about the end of April. I then found him rather worse; he had been applying caustic to the