A treatise on operative surgery : comprising a description of the various processes of the art, including all the new operations : exhibiting the state of surgical science in its present advanced condition ; with eighty plates, containing four hundred and eighty-six separate illustrations / by Joseph Pancoast.

  • Joseph Pancoast
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on operative surgery : comprising a description of the various processes of the art, including all the new operations : exhibiting the state of surgical science in its present advanced condition ; with eighty plates, containing four hundred and eighty-six separate illustrations / by Joseph Pancoast. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    48/554
    chief twisted tight with a stick. This simple contrivance, from the convenience of its application on the field of battle, received the name of the field tourniquet. The garot, as it has been latterly modified, consists of a pad to be placed on the skin above the artery, presenting on its free surface a ring for the passage of the web or strap. On the side opposite the pad is applied a compress, or what is better, a concave piece of horn or metal, upon which the strap is to be firmly twisted with a stick, and the latter given in charge of an assistant, who is to diminish or increase the pressure according to the direction of the surgeon. The compression of the garot extends to the whole substance of the limb—arteries, veins, and nerves—and cannot, therefore, be safely kept up but for a short space of time. The advantage which it offers, of being constructed of the first things at hand, and at any time or place, renders it occasionally highly useful. It cannot, however, be gradually relaxed and tightened with precision like the proper tourniquet, which is always to be preferred. 5. Detached pad, (pad of Charriere,) with buckle teeth on its lateral margins, to which the two ends of the strap are attached. (PI. 7, fig. 5.)—This has but recently been introduced into practice, and is employed for the compression of superficial arteries of medium size. The pad is attached to a plate, and resembles somewhat the lower frame of the French tourniquet, (fig. 4,) and is forced down over the artery, by fastening the two ends of the PLATE VII.—COMPRESSION OF THE ARTERIES. OF THE TEMPORAL AND SUBCLAVIAN. Fig. 1. (A). Compression of the temporal artery, with the pad of M. Charriere, (see fig. 5.) The pad is applied in front of the ear, above the zygomatic arch, and is sustained by a simple strap, the ends of which are fastened upon the two rows of buckle teeth. The double compress under the jaw protects the skin from injury. (B). Compression of the subclavian with the newly devised instrument of Bourgery. This is composed of four principal parts. 1st. A broad rectangular pad (A) screwed to a steel plate, which, though not visible in the drawing, is fastened to a second plate (B). This pad is applied across the attachment of the pectoralis major below the clavicle, which serves as a point of support to it. One end of the pad is thick, so as to fill up the depression below the coracoid process, while the other is thinner and rests on the. sternoclavicular articulation. By reversing the margins, the same pad may be applied for compression of the artery of the other side. 2d. A second plate of steel (B), of the same form as the preceding, upon which it is exactly fitted. They are fastened together by two small pivot keys (b), which enter into corresponding mortises in the plate (A) This second plate serves as a fixed point for the rest of the apparatus. At its ends are two copper pins for the attachment of the straps. 3d. A movable steel plate (C) fastened by a screw to the second plate, capable of being turned for a quarter of a circle to the right or left, so as to suit the obliquity of either clavicle. It serves as a fixed point for the lever of the movable pad (G), with which the compression is made. Above it is attached by a hinge joint (d) on each side with another plate of an elliptical or horse-shoe shape (D), which is thus made mobile so as to adapt itself to the projection of the trapezius. This elliptical plate is padded and provided with two pins (c) for the attachment of the posterior straps. The hollow within it is occupied by the artery pad (G) 4th. The last part of the apparatus is the elbowed lever (E), which supports the artery pad. The base of the upright part of the lever is pierced with an opening, and is fastened by a screw (/) to plate (C) • at its upper part it is attached by a bullet joint (g) to the horizontal arm (F) of the lever, so as to allow the latter to be moved in every direction. The artery pad (G) is in the form of an elongated cone, to penetrate readily between LZ^nZ7 ' ma> m diffCrent direCti°nS hl COnse^ence of * -ode of attachment to the Ttsno:nsT?daKf edB isrheld sr;rely in L\position hy the bod>- ^^ &> ** ** «*«*» ** postenor straps (I and K). By forcing it down with the screw (i) the artery pad may in all cases according to the inventor, be made to act so as to arrest safely the circulation in the vessel. according to OF THE CAROTID AND BRACHIAL. Fig' ^J^SZS^u^Ca plan of a section of the neck; and is so we]1 sho- «not to co'mTessor TSn^T ' ^ ^ ^^ °' *» ta °f the ^ ™* bullet joint, similar to the Fig. 3.—Compression of the brachial artery with the Sneers below the avills, TV r . . , groove over the vessel between the triceps behind and thP 1 , ^ * ^ SUk ,n the ?hnn>h taWc , 1 P d the blcePs and coraco-brachialis muscles in front The thumb takes a support upon the opposite side of the limb. Fig. 8.—Compression of the same artery just above the miihllo nf th„ ■ v ' x. r. „,• . 7 ., . a J uoe im m*uaie oj the arm, is here shown as made bv the rnmmnn English tourniquet; the instrument to which preferencp ^ n.noii ■ • a- * ^oyuiecomraon Nvmcn preierence is usually given in this country. A thick compress or