Ligations of the left subclavian artery in its first portion / by William S. Halsted.

  • Halsted, William, 1852-1922.
Date:
[between 1900 and 1999]
Catalogue details

Licence: In copyright

Credit: Ligations of the left subclavian artery in its first portion / by William S. Halsted. Source: Wellcome Collection.

    5/124 (page 3)
    ANTYLLUS Upon the other great surgical figure of antiquity, Antyllus, so blindly has oblivion scattered her poppies, to quote Sir Thomas Browne again, that not a fact of his life is known; yet through the mists of 18 centuries he looms large as one of the most daring and accomplished surgeons of all time. A resector of bones and joints, one of the first to perform tracheotomy, the founder of the surgery of fistula, a successful operator upon cataract, and we may say the creator of the surgery of the arteries—these are among his known achievements. His remains are chiefly in the works of Oribasius, the physician and friend of the Emperor Julian. Howhere are we impressed with the note of directness so char¬ acteristic of the Greek (see K. W. Livingstone^s Meaning of the Greek Genius, second edition, 1915) as in the brilliant account given by this author of aneurysm, of which he was the first to recognise two forms— one by dilatation, the other following wound of the artery. So far as I can gather, he was also the first to describe the thrill or bruit so characteristic of the latter form. Ho ancient writer has anything like the same accuracy of pathological description, and you may search the surgical literature for centuries before there is found such a gem as the account of his method of operation still in use, and by which his name has been permanently enshrined. Hot finding one in English, I asked Mr. Livingstone, of Corpus Christi College, to give us a com¬ plete translation of the fragment. About Aneurysms (Prom the Works of Antyixus*) ‘ There are two different kinds of aneurysms. The one kind occurs when there is a local dilatation of an artery (this was the origin of the name aneurysm or dilatation). The other kind arises from the rupture of an artery and the discharge of the blood into the flesh beneath it. Aneurysms due to the dilatation of an artery are longer than others; those due to a rupture are rounder. In the former there is a thicker layer of tissue; in the latter you can hear a certain crepitation if you press them with your Anger; while in aneurysms due to dilatation there is no sound. ‘ It is foolish to follow the practice of the ancient surgeons and decline to treat any aneurysm, hut it is dangerous to apply surgical treatment to all types. So we will excuse ourselves from treating aneurysms in the armpit, groin, and neck on the ground that the vessels are large and that it is impossible or dangerous to isolate and tie them. We also decline exceptionally big aneurysms, even if they occur elsewhere. But we will operate as follows on aneurysms in the extremities, the limbs and the head. ‘ If the aneurysm results from dilatation, we will make a straight incision in the skin the whole length of the vessel; then, after separating the edges of the incision with hooks, we will carefully sever all the membranes between the skin and the artery. Then pushing aside with blunt hooks the vein adjacent to the artery, we will expose the dilated portion of the artery on all sides. Next, we will introduce the head of a probe underneath, and, lifting the aneurysm, insert along the probe a needle with a double * “ Oribasius, iv., p. 52 (ed. Daremberg).”