Another case of amputation of the thigh at its upper fourth in which acupressure was successfully employed : with remarks / by P.D. Handyside.

  • Handyside, P. D. (Peter David), 1808-1881.
Date:
[1862]
Catalogue details

Licence: Public Domain Mark

Credit: Another case of amputation of the thigh at its upper fourth in which acupressure was successfully employed : with remarks / by P.D. Handyside. Source: Wellcome Collection.

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    fatal effect of excessive haemorrhage by transfusing the blood of another individual into the veins of the patient.” 7 th, The cases of amputation generally, in which acupressure has been employed, range, I am informed, from thirty to forty in num¬ ber j of which I hope soon to be able to present a summary that may prepare the way perhaps for a cautious induction. These include at least six cases of amputation through the thigh.1 8thy It is interesting to observe, first, how very slight is the amount of acupressure that is necessary2 in order to close a bleed¬ ing vessel j secondly, for how short a time pressure need be main¬ tained 3 in order to produce that effect; and, thirdly, how acupres¬ sure has not been productive hitherto of any unpleasant symptom, or even of any appreciable effect on the adjacent veins or nerves. In applying acupressure is there no risk of producing injurious pressure on adjoining parts ?—is a question that has been asked. In the foregoing narrative it was stated that the artery of the sciatic nerve had been directly compressed; now here was suffi¬ cient compression to arrest haemorrhage from the centre probably of the nerve, and yet no injurious pressure was exerted upon the deli¬ cate nerve tissue. The patient has remained indeed to this day free from any such symptom. But it has been suggested that the great pain in the back that was felt on the day after the operation was due probably to compression of the great sciatic nerve by the long needle employed to control its central artery. It seems clear, however, that this lumbar pain experienced by the patient after the operation depended simply on cold and exposure on the operating table (or, as he himself expressed it, u to cold and the hard bed on which he lay on his back ”); for, while removal of the long needle did not lessen the pain he endured, which became more severe to¬ wards night, and was relieved once and again by the use of a com¬ mon strengthening plaster, applied at his own suggestion (a remedy which, while resident at Sunderland, he had had recourse to for cold), it gradually disappeared from his feeble and exhausted habit under a freer use of wine, an animal diet, and a tonic draught. 1 See a notice of five of these cases in the Journal of Pract. Med. for Nov. 1860, English edition, p. 481. 2 See Professor Simpson’s remarks on this subject in the Edin. Med. Journal for Jan. 1860, p. 645; the Dubl. Hosp. Gaz. for Jan. 2, 1860, p. 7; and the Med. Times and Gaz. for Feb. 11, 1860, p. 137. 3 Illustrative of this remark is the following extract from Malgaigne’s Man. de M6d. Operat., 6tli edit., Paris, 1853, p. 41:—“ Proce.de de Koch.—Apres toutes les amputations, l’operateur ramene le lambeau sur la plaie, et le main- tient par les bandelettes agglutinatives. Une compresse longuette est fix£e sur le trajet de l’artere, a l’aide d’une simple bande. On donne ou moignon une position un peu elevee, et un aide exerce avec la main sur le moignon une douce pression continuee pendant une ou deux heures, et meme aussi longtemps qu’on y ressenq des pulsations considerables. Quand elles ont cesse, et que l’appareil est teint en rouge par la lymphe qui a suinte, Koch assure que tout danger d’h^morrhagie consecutive a disparu, pourvu que le malade reste tran- quille. De semblables promesses n’etaient pas de nature a s^duire beaucoup les chirurgiens, et ce proc^de est justement abandoning” Edinburgh, 11 Hope Street. 15th February 1862.