Ligature of the subclavian artery, in a case of hemorrhage from the axillary artery / by R.J. Mackenzie.

  • Mackenzie, R. J. (Richard James), 1821-1854.
Date:
[1846]
Catalogue details

Licence: Public Domain Mark

Credit: Ligature of the subclavian artery, in a case of hemorrhage from the axillary artery / by R.J. Mackenzie. Source: Wellcome Collection.

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    arm, the limb very soon assumed its natural colour and appear¬ ance. The edges of the axillary wound were covered by pale granulations, but the deeper part of the cavity seemed to have an unhealthy or sloughing surface. The discharge was copious and healthy. A small quantity of dry charpie was laid in the wound. Water-dressing, with oiled silk, was applied to the wound over the clavicle, which looked well. The same dressings were repeated in the evening. 21st.—Passed a restless night, but slept for two hours towards morning, and in the forenoon he appeared very well. Pulse 76; tongue clean and moist; skin cool; suppuration commencing in the wound over the clavicle. One of the stitches was removed, and a bread and water poultice applied. The arm and hand are of natural temperature and colour. The wound in the axilla, as deep as can be seen, is covered by pale granulations. Discharge healthy and diminished in quantity. The cavity was gently clean¬ sed by means of a syringe and warm water, and charpie applied as before. Bowels freely acted on to-day by medicine. 23d.—Was rather feverish yesterday, with heat of skin and dry tongue. Both wounds, however, progressed favourably. He was ordered an antimonial solution, with sulphate of magnesia. To-day he feels much better, having slept for several hours during last night. Pulse 72 ; tongue clean and moist. There is a con¬ siderable degree of hardness, with slight redness around the wound over the clavicle, and strong pulsation is felt over the inner side of the incision. The remaining stitches were removed, and bread and water poultices continued. The wound in the axilla is now covered with healthy granulations, from which there is a copious discharge of healthy pus. 25th.—Going on well in all respects. Pulse 72 : tongue clean and moist; bowels opened twice yesterday by medicine ; sleeps tolerably well at night. A considerable quantity of coagulated blood has been discharged from the wound over the clavicle, the surface of which is now granulating and contracting, being dressed with a sulphate of zinc lotion. Axillary wound contracting, the discharge being considerably diminished. He complains of a prickling pain in the wrist and fingers, which is relieved when the discharge has free vent from the axilla. The pulsation of the radial artery is now very distinct. 29th.—A sinus was to-day discovered running from the wound in the axilla behind the humerus, which, when the patient lay on his back, allowed the matter to collect behind the posterior bor¬ der of the deltoid muscle. A counter-opening was made at this point to give free issue to the matter. The discharge from the axilla has continued to be copious, but the surface of the wound is contracting, and is covered by healthy granulations. The wound over the clavicle is entirely cicatrized, except at the small