On the pathological changes produced in the shoulder-joint by traumatic dislocation : as derived from an examination of all the specimens illustrating this injury in the museums of London / by William Henry Flower.

  • William Henry Flower
Date:
[1861]
Catalogue details

Licence: Public Domain Mark

Credit: On the pathological changes produced in the shoulder-joint by traumatic dislocation : as derived from an examination of all the specimens illustrating this injury in the museums of London / by William Henry Flower. 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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    heightened, the pad removed, and the elastic element withdrawn. There still remains the rod, no longer, however, acting as a screw, but sliding through the ball-and-socket joint beneath so as to admit of the easy introduction of the weight. The weight is ovoid in form, and has a channel through its central long axis large enough to let the rod play easily without catching. The extremity of the weight by which the pressure is applied has the form of the larger end of an egg cut out of metal, 3^ inches in diameter. The inclination given to the rod by the universal ball-and-socket joint determines exactly the amount of weight and the situation at which the pressure is to be applied. A very slight variation in the inclination of the weight from the perpendicular materially modifies the actual amount of weight borne by the limb at the point of compression, so that the minimum amount of pressure sufficient to control the circulation through the artery can be arranged to a nicety, with the same mass of metal. The pressure is rendered accurate by the ball-and-socket joint, which is made immovable by a pinch-screw, or it is directed by the hand of an assistant, sitting at the bedside, steadying the weight or gliding it from side to side as his other hand, resting on the aneurism, may indicate. This apparatus has certainly the virtue of simplicity, as there is nothing eonnected with it which could not easily be con- structed by a blacksmith or brassfounder. So far as I am aware, it has not been previously employed. In editing the last edition of the “ System of Surgery” by the late Professor Miller, I briefly mentioned this apparatus: “ The weight is perforated, and allowed to slide loosely upon the rod of the Carte’s apparatus, its ordinary compressing-pad having been removed.” ^ The only notice I have been able to find of at all an analogous plan of employing weight-pressure in the treatment of aneurism is in the Report of the Proceedings of the Surgical Society of Ireland,^ where Mr Samuel A. Cusack is reported as saying—“ The pressure throughout was made by means of the weights now on the table, which are kept upright and in position by means of a stiff iron wire fixed in a ring in the cradle which is placed over the patient’s body —a mode of applying them which I have found more convenient than any other contrivance in which the patient or an assistant is obliged to keep the weight in an upright position.” The weight employed as a compressing agency has a great ad- vantage over the screw-compressor, whether with the improved elastic element of Carte or not, in so far that it yields with every impulse of the artery, without, however, allowing any blood to pass it. The weight will accordingly be seen to move slightly but quite perce])tibly whenever the pressure is accurately applied, and com- ])letely arrests the circulation. This slight yielding makes the pres- sure far more tolerable than any method which affords no allowance for a certain degree of “ giving.” Further, there is no squeezing of ' A System of Surgery, l>y .James Miller, F.R.S.E., etc., p. 421. * lJublin Med. Press, February 29, 18G0, p. 179.