Application of the button suture to the treatment of varicose dilatation of veins.

  • Bozeman, Nathan G., 1825-1903.
Date:
[1860]
Catalogue details

Licence: Public Domain Mark

Credit: Application of the button suture to the treatment of varicose dilatation of veins. 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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    A few days ago I made an examination of the affected limb, and found it the same size of the other. The cicatrix appeared firm, not showing the least indication of breaking at any point. There are a few branches of the saphena externa, and the trunk of the saphena interna, above the knee, still dilated. It is my purpose to operate again upon the case, and complete the cure.- Case 3.—Elias Smith, plasterer, aged nineteen, of medium stature, and rather sparely built, was sent to me in February last, by my friend Dr. J. C. Batchelor, of this city, to have his leg examined, with a view to an operation. He stated that, ever since he could recol- lect, there had been an enlarged condition of the vein on the inside of his right leg, and of late it seemed to be increasing in size. He said that it gave him no pain now, or inconvenience, but he feared it would, and ultimately might force him to give up his trade. Upon examination, I found that it was the saphena interna which was involved, the dilatation extending from the ankle nearly to its passage through the fascia lata. At a point just below the knee the dilatation was 'greatest, and here the vein was also very tortuous. Having considered the case in all its bearings, I took the view that the man was a laborer, his occupation requiring him to be almost constantly upon his feet, thereby increasing the difficulty, and that, if the disease could be radically cured, now was the time to attempt it. Everything favored a satisfactory result. Accordingly, after such preparation of the system as was necessary, I proceeded to perform the operation, in the presence of Dr. Batchelor, Dr. Frazier, of Arkansas ; Dr. Gilmore, of Mississippi, and several medical stu- dents. The two preceding cases, it will be recollected, were operated upon in the recumbent position. This patient I placed in the erect—and I now greatly prefer this position, for the reason the vein is dis- tended, and the needle can be entered and carried around it with more facility. I introduced five ligatures, two below, one opposite, and two above the knee. This was easily and quickly done. The patient was now made to lie down, in order that the vein might be emptied of as much blood as possible before adjusting the ligatures. The lowest one was arranged first, and the others, then, in legulai succession. The disk of lead and shot were next slid down and secured, as in the preceding case. After-treatment the same as heretofore pointed out. The patient i i IB >1 I >1