The treatment of aneurism of the arteria innominata by ligature of the right common carotid artery / [William Wright].

  • Wright, William
Date:
[1856]
Catalogue details

Licence: Public Domain Mark

Credit: The treatment of aneurism of the arteria innominata by ligature of the right common carotid artery / [William Wright]. Source: Wellcome Collection.

    5/38 page 5
    4. This process ensues as favorably as when induced by any other operation, either artificial or natural. CLASS II. Age. Time of Death after Operation. Cause of Death. State of Aneurism After Death. Surgeon. Y ear. 61 4 Hours. Organic Syncope. More than half filled with consolidated fibrin. Key of London. • •••••«••• 1830. 56 7th Day. Pneumonia. Sac diminished in size, and filled with clots of fibrin. Fergusson of London. 1841. 4S 19th Day. Pneumonia. Sac sl’ghtly diminished, and filled with a mass of strati¬ fied fibrin, weighing 8£ oz. Campbell of Montreal. 1845. 47 66th Day. Ulceration of Sac into Trachea— Bronchitis. Tumor diminished. Coagu¬ lation had occurred, but subsequently had broke down from pus of inflamed Sac. Hutton. These cases, it will be seen, substantiate the deductions that have just been made. But they are chiefly interesting from the information they afford, in reply to the question :— Does the operation entail any special dangers ? These cases, taken in connexion with others in which the carotid artery was tied for innomi- natal aneurism, prove that four-tenths of the operations have been fol¬ lowed by an early death. In the three that are first detailed, the fatal, termination is to be referred to interruption in the circulation, produced by the obliteration of the vessel. In Mr. Key’s case this was unmis¬ takably evident. In it there was an abnormal conformation of the ves¬ sels of the neck, which, had it been previously known, would have pre¬ cluded the operation. The brain was freely supplied by only a single artery, and, as it afterwards appeared, this was the one ligatured. The compensation which under the normal disposition would have been afforded for its obstruction was withheld, for the vessels that remained pervious were so strictured that an insufficient supply of blood was sent to the brain, and syncope or asthenia supervened of an irremediable nature. The aneurism was not the cause of death, for had this lesion not been present, and had the same operation been executed, a similar issue must have followed. The death, then, was due to the operation, not because it was an operation for aneurism, but because it was an ope¬ ration upon the common carotid artery—not on account of any special danger entailed by the aneurism, but on account of a common accident that would have been as surely met, had the vessel been tied for hoemorrhage or any other cause. It were equally absurd to suppose the contrary, as to believe the aneurism was instrumental in producing the coarctation of the left carotid and vertebral arteries that existed. In the
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image