Cases of aneurism / by Robert Liston.

  • Liston Robert, 1794-1847.
Date:
[1820]
Catalogue details

Licence: Public Domain Mark

Credit: Cases of aneurism / by Robert Liston. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    my assistants, at the same time, tried to compress the subclavian, but to no purpose, as the shoulder and arm were much raised to facilitate the dissection in the axilla, which circumstance increased the difficulty of commanding the vessel on the left side. The patient, who had borne the operation well, exhausted by this, and the loss of blood from the very large vessels, sup- plying the tumour, divided in the former incisions, after some efforts to vomit, now dropped his head off the pillow, pale, cold, and almost lifeless. I then only became aware of the nature of the case, and saw that nothing but a bold stroke of the knife could save the boy from immediate death. Pulling out the sponge, therefore, with one rapid incision I completely separated the upper edge of the tumour, so as to expose its cavity ; and, directed by the warm gush of blood, immediately secured with my finger a large vessel at the upper corner, which, with open mouth, was pouring its contents into the sac. With my right hand, I then cleared away the coagula, and dissecting under my finger, separated the great subscapular artery, so that one of my assistants could pass an aneurism needle under it at its origin from the axillary, and about an inch from the sac. After tying this, and two other large vessels, (fully the size of the ulnar,} which supplied the sac, I dissected off’ the tumour from the ribs without further hsemorrhagy, cutting with my knife the carious scapula and under part of the sac. After removing the tumour, 1 found it necessary to saw off the ragged and spongy part of the scapula, so as to leave only about a fourth part of that bone, containing the glenoid cavity, processes, and half of the spine. In this way, ten muscles * were either wholly or partially divided. The edges of the wound were then brought together, and the patient cautiously lifted into bed. At this time he was pale, almost insensible, and without any perceptible pulsation in the greater arteries through the integuments, though the ends of the vessels in the wound beat very forcibly. By the exhibition of stimuli, externally and internally, his pulse could by-and-by be felt, though, on account of its quickness, it could not be counted. In the evening, however, it was at 90, and soft. 26th.—The wound is now completely filled up by healthy granulations, and contracting rapidly; discharge by no means profuse, nor has it been so ; appetite good ; pulse 80 and soft; * LatiMimu* Dorsi—Trapezius—Deltoides—Rhomboideus Major—Infra- spinatus—Supraspinatus—Subscapularis—Teres Major—Teres Minor—Serra- tus Magnus. 1