A system of practical surgery / by William Fergusson.

  • William Fergusson
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: A system of practical surgery / by William Fergusson. Source: Wellcome Collection.

    182/878 (page 158)
    the Edinburgh Medical and Surgical Journal; and I need not here state more on the subject than that I assisted Dr. Maclachlan when he introduced the needies for the first time (four in number), and that the cure was accomplished in seven months by careful pursuance of the same plan, eight needles being all that were required through- out the treatment. Very recently I had an excellent result from this style of operation, in a young female patient at King’s College. A most extensive vascular tumour occupied the site of the mamma, and so involved that gland, that it would have been impossible to remove the disease with the knife or ligature, without sacrificing that important organ. By applying needles and ligatures over them at various places around the mass, most of the large vessels were obli- terated, and a most satisfactory cure followed, with the mamma uninjured. Some years ago an exceedingly interesting case of this description came under my care. A young woman about twenty-two years of age became a patient of my friend Mr. Robert Storks. The ves- sels of the scalp, particularly on the left side, were enormously dis- tended, as may be here seen (figure 72). Both arteries and veins were involved, but the veins seemed most affected. The vessels were slowly increasing, and the girl felt unfit for her usual occupation as a housemaid. Ligature of the common carotid was resorted to by Mr. Storks, and considerable improvement followed. Pressure on the scalp, by means of elastic caoutchouc bands, had now more effect than before; but still the veins continued of vast calibre, and ere long arterial pulsation could again be felt. The patient could not resume her duties, and earnestly desired that, if possible, something more might be done. She then came under my care in King’s College Hospital, when I adopted the plan above referred to. Long needles were passed under and through the vessels at various prominent points. These were sufficiently strong to bear the pressure made by twisting strong threads about them over the included vessels and scalp, and it was resolved to leave them until there seemed necessity to interfere. At some points sloughing occurred; elsewhere ulceration loosened the needles, and throughout the parts interfered with there was inflammation and induration. In about three weeks a result took place which I had anticipated; violent hemorrhage came—happily during my visit to the hospital. Pressure with the fingers was adopted, until the old needles were withdrawn and fresh ones introduced; when threads were again applied and the bleeding was arrested. Further inflammation and obliteration of vessels ensued; hemorrhage, which occurred on several subsequent occasions, was arrested in a similar manner by my assistants, who were constantly on the alert at periods of danger, and the result of the practice was the total obliteration of all the formidable affection, with firm cicatrices marking where the sloughing and ulceration had been. The patient, when I last saw her, many months after she had been under treatment, was quite well, and able for any ordinary occupation.