Volume 2

Observations on aneurism selected from the works of the principal writers on that disease from the earliest periods to the close of the last century / Translated and edited by John E. Erichsen.

  • John Eric Erichsen
Date:
1844
Catalogue details

Licence: Public Domain Mark

Credit: Observations on aneurism selected from the works of the principal writers on that disease from the earliest periods to the close of the last century / Translated and edited by John E. Erichsen. Source: Wellcome Collection.

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    popliteal artery. This tumour had acquired the size of a turkey- hen’s egg. The patient was thirty years of age, of a sanguine and irritable temperament, and of a restless disposition; he suf- fered violent pains in the leg and foot, and more particularly at the anterior and inferior part of the tibia. After proper pre- paration Desault operated. He made an incision fifty-four millimetres (about two inches) in length at the upper part of the tumour, laid the artery bare, separated it from the nerve and tied it. The dressings were simple. Three hours after the operation the patient experienced a slight sensation of cold in the leg, which lasted a short time ; the symptomatic fever was not severe. On the sixth day Desault tied a ligature of reserve, that he had placed under the artery, above the first one. The state of the wound and of the patient was such as to promise a speedy cure. The tumour was diminished to half its size, and the oedema of the leg had disappeared. There was nothing to wait for but the separation of the hgature, which occurred on the eighteenth day. On the following day the wound discharged a tolerably large quantity of matter mixed with blood, and the tumour disappeared almost entirely; an evident sign of the rup- ture of the aneurismal sac. After this nothing was left but a fistulous opening which healed in a few days. The aneurism was cured, but some unfavorable symptoms supervened which appeared to have been the effect of the obliteration of the prin- cipal artery of the limb, and which caused the death of the patient a long time afterwards. attached to it at the time, even by Desault himself: “J’ai demeuré,”’ says Maunoir, ‘deux ans chez Desault, et je ne me rappelle pas l’avoir jamais entendu parler de cette opération. Elle n’a été consignée nulle part ; et, en général, il me parait qu’on la cité sans la connaitre, et d’aprés des relations fort vagues.” (Note top.50 of the Mémoire Physiologique et Pratique sur l’Anévrisme et la Ligature des Artéres ; Généve, 1802.) From the observations by Sabatier, as reported in the text, as well as from those that Deschamps makes on the same subject, there cannot be the slightest doubt that Desault merely performed Anel’s operation on the popliteal artery ; that is to say, the popliteal artery was ligatured immediately above the aneurismal sac, which was left untouched; and from Maunoir’s remark it would appear that he did not attach much importance to this departure from the usual mode of procedure, and most certainly did not look upon it as involving a new principle in the treatment of aneurisms. On a reference therefore to the statement of contemporary writers, and on an examination into the details of Desault’s case, there cannot be the slightest doubt left that with John Hunter rests the merit of having been the first surgeon who tied the artery at a distance from the aneurismal sac. ] 1796.