Ligature of both carotid arteries for a remarkable erectile tumour of the mouth, face and neck / by J. Mason Warren.

  • Warren, Jonathan Mason, 1811-1867.
Date:
[1846]
Catalogue details

Licence: Public Domain Mark

Credit: Ligature of both carotid arteries for a remarkable erectile tumour of the mouth, face and neck / by J. Mason Warren. Source: Wellcome Collection.

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    arteries tied, and from the probability of its having other means of supply through the vertebral arteries, which inosculate freely with the branches of the internal carotid, the ophthalmic in this case being unusually dilated. The second mode of operating which suggests itself, is to expose the differ¬ ent vessels supplying the tumour, and pass a ligature upon them. The objection to this course is the length of such an operation as the exposure of so many vessels would require. 'Are there any other means that can he devised besides these two ? The tumour is much too large to admit the safe and effectual application of caustic. It cannot be cut out without the most dangerous hemorrhage. It is too large and too much connected with the bone to admit the application of ligature en masse in its present state. Oct, %\st. Having compressed, on the right side, the temporo-frontal and two temporo-parietal arteries, and on the left side the continuation of the temporal artery through the frontal region, and the temporo-parietal, the pulsations of the tumour appeared to be arrested, and its contents were readily expelled through the large veins, running into the facial vein. Ob¬ serving this we determined to interrupt the circulation through the five vessels first mentioned, three on the right side, and two on the left. In¬ stead of exposing and taking up these vessels in the usual way. Dr. J. C. Warren suggested that much time and loss of blood would be spared by passing needles under them. This was accordingly done, and the arteries were compressed by a ligature thrown over the needles in the form of a figure of 8. After this the pulsation of the tumour was much diminished. Venesection was then performed, and the patient placed in bed with his head elevated. Nov, Qth, The needles were removed. Very slight soreness had been experienced from them. The tumour is diminishing in size; the vessels constituting it appear more flaccid and compressible. The soreness and all the uncomfortable sensations connected with it are lessened. 12^A. The pulsations in the right and left temporal arteries still continu¬ ing, a needle was passed under each of these directly above the ear, after which the pulsation subsided, and also the general sense of beating about the head. The patient is much more comfortable. 21s/. In consequence of a slight bleeding from the wound of a pin in¬ serted on the 16th, we thought it best to obstruct the vessels on the ante¬ rior, and on the internal part of the tumour, and passed pins in each of these situations. There is now no pulsation in the tumour; the tenderness existing on the upper part before any operation has been increased. He had a chill from going into another room in the house; since that has had some fever. 22t/. At this date there was a sudden rupture of the tumour attended with considerable hemorrhage. Being hastily called to the patient, I passed two large pins at right angles with each other under that part of the tumour from which the hemorrhage was taking place. A ligature