On acupressure in amputations : with illustrative cases / by J.Y. Simpson.

  • James Young Simpson
Date:
[1860]
Catalogue details

Licence: Public Domain Mark

Credit: On acupressure in amputations : with illustrative cases / by J.Y. Simpson. Source: Wellcome Collection.

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    capable of sustaining, without danger, any prolonged or severe local morbid action. For entire closure of the operation wound by the first intention would transform a cure which usually lasts for many weeks into a cure of almost as many days ; it would save the patient from the protracted suffering and distress produced by the continued dress¬ ings and discharges; and no doubt it would avert in many instances the dangers of pysemic poisoning and surgical fever arising from the absorption of decomposing matters produced by local suppurations and sloughings in the depths of the wound. But, for the reasons above adverted to, complete closure of an amputation-wound by the first intention is extremely rare, or, indeed, impossible, when ligatures are employed to secure the bleeding vessels. On the contrary, surgical wounds under the most disadvantageous circumstances, readily enough unite by the first intention when arte¬ rial ligatures do not happen to be employed—as we see in the primary adhesion of the wound in hare-lip, despite the presence of the saliva; in the successful reunion of the revivified lips of vesico-vaginal fis¬ tula, despite the constant contact of urine; in the rapid closure of the wound in lithotomy; and in the success attending upon the whole class of operations included under the term of “ plastic sur¬ gery”—a dass of cases in which arterial ligatures are almost never employed. Under the name of acupressure, or acupression, I some time ago proposed a plan of arresting haemorrhages in Surgical wounds and operations by the employment of metallic pins or needles instead of ligatures. For the mode or modes of using these, I can only here refer to the descriptions which I have elsewhere published on the sub¬ ject.* They have this one very great advantage over ligatures, that the heads of the needles being left out on the cutaneous surface of the flap, the needles themselves can thus in every case be entirely with¬ drawn in forty or fifty hours, or as soon as the complete closure of the artery has been established, leaving no foreign body whatever in the flaps or walls of the wound to prevent their speedy and complete union. Besides, during the brief period that they are thus left in the wound, they are, as contrasted with organic ligatures, comparatively innocuous. -For, in accordance with the general pathological law of the tolerance of animal structures for metallic bodies imbedded in them, metallic needles cause little or no irritation by their presence, as seen in the harmless retention for months or years of bullets, small-shot, pins, etc., in the body ; in the relative innocuousness of long needles introduced and lodged for the purpose of acupuncture ; in the non-irritating character of iron, silver, and other metallic threads, when used as Surgical sutures; in the employment, by all our best Surgeons, of metallic pins or needles in the union of hare-lip, where the whole aim and object of the operation is to secure and establish primary ad¬ hesion of the lips of the wound; and in the safe retention, during * See Edinburgh Medical Journal for January 1, I860, p. 645, and Dublin Hospital Gazette for January 2, 1860, p. 7.
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