The Leavenworth weekly times. [volume] (Leavenworth, Kan.) 1870-1880, 1875-06-03

inferred from statement which l heard |
the late DR.. Valentine Mott make, to the !
effect that he once saw Sir Ashley Cooper
fail in an Effort to tie the sub clavian ar
tery. There il one way, however, in which
the difficulty might be overcome, and that
is by cutting out a part Of the collar-bone
with chain saw, and in this way expose
the artery which would really he the most
feasible and defensible plan in the case be-
lore us. :,
Now let US approach the case. The ball
has done its work, the surgeon Is called.
There is no chance to operate now no way
of COMPRISING the artery. All that can be
done is to fill the wound with some stytic
sponge soaked in Persulphate OF iron Is
the best and this should be forced along
the track of the wound with probe. The
patient bleeds, swoons away life TOR q mo-
ment seems to be extinct, but the falnt-
ing checks the hearts vigorous impulses
and clot forms, and consciousness and life
gradually return. A few hours pass over
the patient and he still lives; and the
question propounds itself to the surgeon,
can ! save this man by an oPer-
alton? If / try TO do 80, l under
take the most difficult operation in my pro-
fession under the most forbidding circum-
stances / cannot operate without cutting
some blood vessels, and can this man lose
| any more blood and live? Again, this OPP
| Grafton imposes great shock on the ner-
yous system. and in his almost exsangui-
neous condition, can he sustain the shock
| of the knife in addition to that already in
| fiicted by the bullet? Again, the surgeon
says to himself, the very position in which
| have to place this man. in order to oper-
ate on him, NAV force out the clOt and
start the bleeding anew, and he will bleed
to death in spite Of me before l can reach
the artery. But again, the surgeon says :
Suppose / reach this injured artery and
nut a ligature around it, do / know that
| there is room enough between the severed
point and the first branch given off toward
the heart for a permanent clot; and Is
there not a strong probability that when
the ligature comes away there will be sec
ON dary bleeding and death? The entire
length Of the external third is one inch and
a half, and at its commencement, where II
Joins the middle third, there are large YES
sells given off from it. As the course of the
ball is through this part there may not be
more than one inch or even one-half an
inch left for the clot to form in, and stay
/
lateral branches are endeavoring to adjust
themselves TO the capacity and work re-
auired of them. The ligature, too, must bt
slipped up on the artery, in order to holt
itself, and when it comes away or rots of
las it must), it brings part OF the artery
with it, still diminishing the extent of tn,
occluded vessel.
All these difficulties must be carefully
L n Ii L. L.
fore Us, until the conclusion was made tina
an operation could avail nothing.
What, then, is to be done? NOthin.
else can be done than to keep the WOUND
filled with styles, chief among which i
the presulphate of iron. He must not b
1 fed or stimulated much, otherwise the Wig
e or of the hearts action will force out tn
clot, and he will bleed to death; and h
must he fed and stimulated enough to keel
his blood from becoming impoverished, o
1 the wound will slough, and he will blee,
a to death. In balancing these extreme
lies the difficulty. Can styles undo
such circumstances retain bleeding? hav
no hesitation in saying they can in vessel
:, more distant from the heart. Severa
!, cases OF recovery came under my observa
ton during the I" late unpleasantness," bu
none in which this remedy proved efiectiv
' in an artery so close to the heart As the sui
$ clavian.
\ At what time will wound OF this char
n acter most likely prove fatal? l answe
from the eighteenth to the twentieth da,
= All writers on military surgery, before tn
: late civil war placed secondary bleeding a
: too early date, from the fifth to the mint
+ day after the primary bleeding. The e,
perience of American army surgeons got
to show that the twentieth day is the mo-
e critical time, when secondary bleeding
II apt to occur. At this time a supuration
% going on along the track of the wound, I'll
patient is free from shock and I'll
heart begins to act more vigoronsl,
though the collateral circulation is onl
partially established, and the patient h
y comes FESTIVE under the restraints of h
n medical attendants and regards his war;
~ ings as professional suPererogation, AIT
: acting on his own impulses, the clot e
u capes and the luckless subject bleeds
l. death almost before he knows it. Such o.
e currences will be readily recalled by medi
- al gentlemen who were attached to oil
hospitals during the late civil contest.
IL Trusting this article will CRAFTY the CT
= riositv and interest of your readers, / an
d Mr.. Editor, respectfully yours,
II J.F, MD.
-Eansus Cty Times.