Surgical cases in 1867 / by David W. Cheever.

  • David Williams Cheever
Date:
1867?]
Catalogue details

Licence: Public Domain Mark

Credit: Surgical cases in 1867 / by David W. Cheever. Source: Wellcome Collection.

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    artery above, and to pass between it and the vein. The point was then directed downward to pierce the adductor muscles beneath the vein. It was hoped thus to compress the artery, without pressing on the vein. This manoeuvre failed to control the pulsation, and was abandoned. The artery being lifted on a director, the acupressure needle, piercing the sartorius and crossing over the artery as before, was now passed between the artery and vein, and the point turned outwards along the director, and beneath the artery, until it pierced the rectus muscle and rested on the femur. Thus the artery was lifted away from the vein, and compressed between the pin and the sartorius and skin. All pulsation immediately ceased in the aneurism and below. The wound was closed externally by three wire sutures, the pin being left in place, with the head alone protruding. 12, M.—Patient was placed in bed, with leg slightly flexed. Special watch. Having observed the great rise in temperature following lesions of the sympathetic nerve in the lower animals, through some impression, probably, conveyed to the versa vasorum; and having also noticed a simi¬ lar increase of heat after the ligature of large vessels, I directed that the limb should not be packed in wool, as is ordinarily done after ligature, but be left uncovered, and the temperature carefully watched. External warmth was to be applied if the heat of the limb or foot fell below that of the other. 12.52, P.M.—Temperature in axilla, 98.5° ; in groin, 97.25°. Left leg (the leg affected), four inches below the knee, 95.5°; right leg, four inches below the knee, 93.5°. 2, P.M.— Recovered from effects of ether. Complains of darting and sting¬ ing pains in sole of foot, calf of leg and seat of aneurism. 5.15, P.M.—Temperature the same. Pain continues, with slight twitching of muscles of calf. Milk ad libitum, and sulphate of morphia to be given pro re natd. 6, P.M.—Pain undiminished. Morph, sulph. gr. J, subcutaneously. 8, P.M.—Pain continues. Morph, sulph. gr. J, subcutaneously. 10.15, P.M.—Slight spasmodic contractions about seat of aneurism. No pulsation. Pulse 88. 11.45, P.M.—Very restless. Morph, sulph. gr. J, subcutaneously. Very slight oozing from the wound. 7th, 6.30, A.M.—Rested well the latter part of the night. One dejection at 4, A.M., and another now. Darting pain in leg and popliteal space. Aneurismal tumor smaller, hard and tender. Leg and foot somewhat swollen and oedematous. Twenty drops of tincture of opium to control tendency to diarrhoea. Milk and cracker for breakfast. Pulse 96. 8, A.M.—Vomited soon after taking lauda¬ num. One loose dejection. Morph, sulph. gr. J, subcutaneously. Tongue dry and coated. Much thirst. Broken ice by mouth. 10.30, A.M.—Drowsy. No very severe pain. Diet of milk porridge and boiled milk ad libitum. 12.35, P.M.—Two discharges since last record. Pil. opii gr. J, after each dejection. 2.30, P.M.—Peels quite comfortable. Pulse 104. One dejection. Continue opium 2