The cure of epilepsy and of inveterate uterine displacements / by William Alexander.

  • Alexander, William, 1844-1919.
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: The cure of epilepsy and of inveterate uterine displacements / by William Alexander. 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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    part of tlie internal intermuscular septum, for tlie purpose of relieving tlie pain complained of there after the epileptic attacks. Bromide of potassium was prescribed. The wound healed without any trouble, and the twitchings were lessened, but the epileptic attacks continued as usual. On August 171 ligatured the left vertebral artery by cutting down upon its course. Between the sterno-mastoid muscle and the scaleni muscles there is a depression in the necks of all but excessively stout individuals. Along this hollow, in a direction upwards and outwards, I made an incision about four inches long. The incision began just outside and on a level with the point where the external jugular vein dips over the edge of the sterno-mastoid. The internal jugular vein soon came into view, and was drawn inwards; next a zone of glandulo-adipose tissue appeared, and on tearing through this with a probe or director, the transverse cervical arteries with one or two veins could be seen. These were retracted to the outer side. The wound was now pretty deep, and a good light and careful retraction of the lips of the wound were necessary, as excessive or rough handling might have injured the internal jugular vein on the inside, or the phrenic nerve on the outside; while at a short distance below lay the pleura surmounted by the subclavian vessels and their branches. In this case, when I reached this stage of the operation, and scratched through the fascia covering of the longus colli, no vertebral artery could be seen. I then separated the fibres of that muscle, and came upon it just below its entrance into the spinal canal. The heart did not show any disturbance when the ligature was tied. The wound was washed out carefully with carbolic acid and stitched up completely, drainage-tubes being superfiuous in this region, where absorption and union are so rapid that tension does not occur. The operation was almost completely bloodless. Just after the operation the patient had a fit. During the afternoon his body twitched a good deal, but there waa no un- consciousness or other symptom of epilepsy. *