Remarks on osteo-aneurism : with a case involving the condyles of the left femur / by J.M. Carnochan.

  • John Murray Carnochan
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on osteo-aneurism : with a case involving the condyles of the left femur / by J.M. Carnochan. Source: Wellcome Collection.

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    tion to the circulation, above the seat of the disease, by ligature or by compression, might prove as successful in one disease as it was known to be in the other; but in practice, the ligature of the principal artery, above the seat of the disease, has not been entirely successful. In 1819 Dupuytren, acceding to the doctrine of Breschet, that Osteo- aneurism was formed by an erectile tissue, for the first time, applied the ligature upon the artery, above the seat of the disease. Since that time we have the records of four cases, treated upon the same princi¬ ple ; one related by Lallemand, two by M. Roux, of Paris, and one by M. Nelaton. These five cases comprise all that are known, where the ligature has been applied upon the cardiac principle, for real Osteo- aneurism. In other instances of pulsatory tumor, where resort was had to the ligature, it was ascertained by the progress of the disease and by the morbid appearances upon examination, that the supposed Osteo-aneurism was, in fact, an eneephaloid degenerescence of the osse¬ ous tissue. In the case described in this paper, the trial of the liga¬ ture was made for the sixth time. A review of these several cases will show that the efficacy of the ligature as a remedy for this disease is not to be relied upon. In the case operated on by Dupuytren, pulsation ceased and the tumor so de¬ creased that the patient was declared to be cured; but after a time the tumor commenced again to enlarge, and the disease, protracted during a period of nearly six years, ultimately required amputation. In one of the cases related by M. Roux, where the aneurism was seated at the inferior extremity of the radius, the ligature of the brachial ar¬ tery was unavailing, and amputation was afterwards performed. In the other case related by that surgeon, and also in the case related by Lallemand, the cure of Osteo-aneurism of the upper extremity of the tibia, by tying the crural artery, is claimed j but as reported, these cases were observed and followed for only a few months after the operations, and are therefore not altogether satisfactory, as regards the affirmation of entire cure. The report of the case in which M. Nelaton tied the femoral artery for Osteo-aneurism of the inner con¬ dyle of the femur, is not complete; but as far as it goes, it acknow¬ ledges that, within a month after the operation, pulsation had returned and the tumor was not decreasing. The use of the ligature, however, is expedient, especially in the early stage of the disease. Its applica¬ tion is attended with but little danger to the patient, and if successful, saves him from a severe mutilation. When the diagnosis is ascertained, before the disease_has made
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