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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    wards. Yesterday (he continues), at a case of removal of the mamma, I again used the needles, and easily arrested the hemorrhage from two arterial branches which were spouting freely in the upper or axillary flap. A small branch of an intercostal was the only other bleeding vessel, and torsion was used for it. Nothing could have been easier or more beautiful than acupressure applied in this case, as the proce¬ dure was seen in its simplest form—more so than in a flap. I see,” Dr. Greig adds, “that in France M. Foucher* has tried acupressure on the dead subject, and also on a dog. I wonder why he did not try it in an amputation. Nothing can be easier; and if a Surgeon uses it once I am sure he will do so again.” Case III.—On January 30, I had an opportunity kindly afforded me by Mr. Edwards, lecturer on Surgery here, of applying acupressure to stop the bleeding following an amputation of the foot through the first row of tarsal bones. The patient had been unable to work for one or two years, in consequence of an injury to the foot, which led to necrosis, and intractable caries of the anterior row of tarsal bones. He was a strumous subject, and his health was much damaged and broken down by the effects of the disease. Mr. Edwards performed the operation with great dexterity and rapidity, and the four or five vessels that bled were easily secured by as many acupressure needles. The section of the astragalus showed the existence of some disease in its cancellated tissue, which necessitated the removal with the gouge of a portion of its structure. The whole surface of the bone laid bare by the saw and gouge was vascular, and continued to ooze out blood as long as it was exposed. But as the patient was very weak and reduced, Mr. Edwards was anxious to close and stitch up the wound as soon as possible, and before the chloroform-sleep was over. The needles were all removed from the stump about fifty hours after the amputation. During the two subsequent days, there twice occurred a slight oozing of blood from the outer angle of the wound, but not more than enough to redden the moist dressings; and this altogether ceased on the removal of an old ash-coloured clot from the situation above mentioned. To-day (eight days from the date of the operation), the stump is healing kindly, and the patient feels well. Case IY.—In the preceding three cases of amputation, acupres¬ sure was effected by passing the needles from the cutaneous surface of the flap, over the track of the bleeding vessel, and then causing their points to emerge through the skin at some distance. In other words, in all of these cases the cutaneous portion of the flap was used as the point of resistance against which the wounded artery was compressed by the bridge of needle passing over it. In an instance of am¬ putation of the leg immediately below the knee, performed on January 31, in the Hospital at Carlisle, by my esteemed friend Mr. Page, I * See Medical Times and Gazette for January 21, p. 72.
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