The collateral circulation in aneurism : report of the successful ligation of the innominate, the common carotid, the vertebral, and the internal mammary arteries in a case of right subclavian aneurism / by A.W. Smyth.

  • Smyth, A. W.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: The collateral circulation in aneurism : report of the successful ligation of the innominate, the common carotid, the vertebral, and the internal mammary arteries in a case of right subclavian aneurism / by A.W. Smyth. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    from a full and careful consideration and study of the case. If I am correct, however, in the conclusions at which I have arrived, and which I am now prepared to state, the time taken will not, I think, be pronounced wholly lost. The subject of aneurism is very different to me now from wliat it had been. The rationale of the cure of the disease, and the action of the various methods adopted to brinj^ about a cure, are more comi>rehensiblc to me. In fact, although 1 had cured many aneurisms, 1 never knew exactly until now how they were effected. I have learned more from failure than from success, and better understand much that 1 have read and seen in the past. Before entering upon this sub- ject, however, 1 think it of importance to give some particulars of the case not yet stated, or not as fully stated as the reader may desire. The exact time of the return of the aneurism is uncertain. Banks stated on his coming to New Orleans in September, 1.S7-1, that the tumor had commenced returning about a year previous to that time. Some swelling and pulsation had existed, liowever, even before this returning was acknowledged ; for Trof. Paul F. Eve, of Nashville, Teun., called my attention to a notice of an examination of Banks previously made in Galveston by a surgeon of the United States Army, and mentioned in a report to the Surgeon-General. 1 cannot now turn to this report, but it was of much earlier date than the time given by Banks as that of the returning of the aneurism. The writer statetl that slight pulsation existed in the sac of the aneurism, which however, he did not then consider of any immediate import. It may api)oar strange to the reader that thcsu[)ply of blooil to the aneurism through the subscapular artery was not dis (U)vered during life; but there is an ex])lanation for this. 'I'lie palicnt, during the time of his recovery from ligation of lh<^ internal mammary artery, was examined by many ju'ofessional gentlemen,—by all the leading surgeons of New Orleans, and by other visitors, among whom 1 may mention Dr. Itobert McDon- nell, of Dublin, then present in our city. 1 considered that the frcfiuent (examinations during these visits cau.sod the ab.sce.ss