Case of traumatic spreading gangrene, after severe compound fracture of the leg, for which amputation beneath the trochanters was performed, and the arteries secured by four acupressure needles : the femoral artery, at its giving off the profunda branch, was relieved from pressure at the forty-ninth hour after the operation; with recovery : and remarks / by P.D. Handyside.

  • Handyside, P. D. (Peter David), 1808-1881
Date:
[1860]
Catalogue details

Licence: Public Domain Mark

Credit: Case of traumatic spreading gangrene, after severe compound fracture of the leg, for which amputation beneath the trochanters was performed, and the arteries secured by four acupressure needles : the femoral artery, at its giving off the profunda branch, was relieved from pressure at the forty-ninth hour after the operation; with recovery : and remarks / by P.D. Handyside. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    before; tongue alisteiiing and red; thirst considerable; pain excru- ciating; patient restless and unmanageable; leg hot, swollen, and red ; no discharge from wounds—edges elevated, swollen, and dry; slight tension on the sutures. July 9, 10 A.M.—Countenance less indicative of pain, but still anxious; patient has slept but little; tongue moist, but furred; skin perspiring freely; thirst less intense; pulse softer, 96; pain much less severe, at times altogether absent; leg swollen, but puffy, mottled, red, and colourless; temperature rather below the normal standard; wounds discharging an offensive briny fluid, edges soft and flabby; gangrene is suspected. 8 P.M.—Pain almost gone; countenance anxious, but of a natural hue ; tongue dry and coated ; skin as before ; thirst constant ; pulse 100, and feeble ; patient losing strength; mind irritable and unsettled; leg pits slightly on pressure—is colder and mottled—of a darker, almost purplish, colour in some parts; wounds not discharging, their edges are flattened, and of a dark red colour; gangrene evident, and spreading upwards, being already one inch higher than the wound over the tibia. July 10.—Symptoms of gangrene more marked ; pulse 104, get- ting weaker; patient restless, and losing strength rapidly; tongue brown, and mouth dry; countenance pale and meaningless; skin covered with a clammy perspiration ; leg cold, and of a darker purple hue; one phlyctena near the wound over the tibia, beyond which the gangrene has spread 2^ inches upwards in irregular lines. July 11.—Pulse 106, weak, and irregular; patient considerably weaker; tongue and mouth foul, and more dry; skin clammy; countenance pale and more meaningless ; features small and i)inched ; patient disposed to lie quiet and silent, unless roused; gangrene of leg still spreading, now within two inches of knee-joint, of a purple colour, almost black, with shades of dark green and yellow inter- spersed; phlyctenaj general; offensive fetor; limb quite cold below line of wounds; patient still feels some pain on firm pressure being made on the gangrenous parts; wounds putrescent and moist; pulsation still distinct in popliteal space ; no line of demarcation traceable. A consultation was held between Drs Todd, Dewar, and Bonthron, when it was resolved to amputate above the knee-joint. July 12.—Gangrene yet spreading, is now within a few lines of knee-joint at advanced parts; physical ])henomena in leg more dis- tinctly and intensely marked; pulse rapid, weak, and irregular; respiration heavy and sighing; strength prostrated ; mind unsettled, except when rou^sed ; speech somevvhat inarticulate ; countenance pale, and contracted in the features ; skin cold, and bedewed with a clammy sweat; putrefaction going on rapidly in the dead limb. That afternoon I was called in consultation, and met Drs Todd and Bonthron of Dysart, and Dr Dewar of Kirkcaldy, on the question as to whether amputation at this late period might save the patient. I found M' with a sunken aspect; tongue dry and furred;