Observations on aneurism : and its treatment by compression

Front matter

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Chapter I

Page, History of the cure of aneurism by compression from the earliest period to the middle of the 18th century— Origin of the employment of compression in aneurism — Pressure at an early period applied always to the aneurismal sac, limited to cases of brachial aneurism — .Earliest cases of the successful employment of compression — Instruments for applying pressure invented during this period — Description of" the instruments of Bourdelot, Scultetus, Valiant, Senffio, Arnaud, Heister, and Foubert — Bandage of Genga — Theory of the mode in which compression was supposed to effect the cure of aneurism, ... ... 1

Chapter II

History of compression in aneurism from the middle of the 18th century to the period of the first performance of the Hunterian operation — Heister the first to propose the employment of pressure in popliteal aneurism — Guattani the first to succeed in curing popliteal aneurism by compression — Cases reported by Guattani — Compressing instrument of Vicq d' Azyr — Erroneous theory upon which pressure was used at this period — Injurious consequences likely to follow the application of pressure to the aneurismal sac — Mode of applying pressure termed immediate ; described by Sabatier — Theory upon which it was supposed to effect the cure of aneurism, ... ... 12

Chapter III

History of compression in aneurism subsequent to the introduction of the Hunterian operation — The pressure now for the first time applied upon the artery tetween the aneurism and the heart — Theory upon

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Page, which compression was used at this period — Experiments of Mr. Freer; cases given by him — Earliest examples of the successful employment of compression upon the artery above the sac in popliteal aneurism recorded by Pelletan, Dubois, and Viricel — Successful cases subsequently reported by Dupuytren and Boyer — Unsuccessful cases recorded during the sameperiod, 26

Chapter IV

History of compression in aneurism subsequent to the introduction of the Hunterian operation, continued — Cases recorded by the late Mr. Todd in the Dublin Hospital Reports — First successful case communicated to the Surgical Society of Ireland by Mr. M'Coy — Successful case treated by Mr. Todd — Successful case recorded by M. Verdier — Immediate compression of the artery leading to the aneurismal sac — Description of the presse-artere of Deschamps, Ayrer, Percy, Duret, Dubois, Assalini, Crampton, and Ristelhueber — Successful cases treated by Sir Philip Crampton — Compression of the artery at the distal side of the aneurism — Cases in which this method has been tried, ... ... ... ... ... ... 43

Chapter V

History of compression in aneurism, continued — Cases of popliteal and femoral aneurism successfully treated by compression from the year 1826 down to the present day — Unsuccessful case recorded during the sameperiod, ... ... ... ... 64

Chapter VI

Description of the instruments employed for making pressure upon the artery above the sac in the treatment of femoral and popliteal aneurism — The tourniquet truss — Mr. L'Estrange's tourniquet — Sir Philip Crampton's presse-artere — The clamp — Oke's tourniquets—Messrs. Read's aneurism compress — Signorini's tourniquet — Charriere's compressor — The ring tourniquet — The weight — Mr. Carte's apparatus for

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applying the weight — Messrs. Read's apparatus for applying the weight — Compression by means of two instruments applied upon different parts of the limb, and alternately relaxed — Mr. Millikin's double-padded compressor, 84

Chapter VII

Employment of chemical agents to coagulate the blood contained in an aneurismal sac — Case in which heat was employed with this object — Cases in which galvano-puncture has been used — Mode in which galvanism acts in causing the formation of a coagulum from the blood — Theory upon which galvano-puncture effects the cure of aneurism — Injection of chemical fluids into the sac of an aneurism, ... ... 98

Chapter VIII

Theory upon which compression was supposed to effect the cure of aneurism from the period of the introduction of the Hunterian operation down to the year 1843 — Opinions of writers on aneurism during that period, bearing upon this mode of treating aneurism — Opinions of Hodgson, Guthrie, Sir A. Cooper, S. Cooper, Lawrence, Colles, Gibson, Begin, Boyer, Todd, and Hunter — Theory laid down by the author in the year 1843 as to the mode in which compression acts in bringing about the cure of aneurism, and as to the amount of pressure necessary to produce this effect, 116

Chapter IX

Description of the appearances found in subjects who had been submitted to the treatment by compression, and who died either previous to or subsequent to the cure, 130

Chapter X

Mode in which nature effects the cure of aneurism — Distinction between a coagulum and the fibrinous deposit found in aneurismal sacs — Proofs that com-

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Page, pression effects the cure of aneurism in the same way as nature accomplishes this object — Proofs that the ligature of the artery at a distance from the sac effects the cure of aneurism in the same way as compression— Spontaneous cure of external aneurism, ... 135

Chapter XI

Circumstances which may render the cure of aneurism by compression tedious or the contrary — Circumstances connected with the instruments used, the mode in which the compression is applied, or the situation at which the pressure is made — Circumstances connected with the patient, his state of health, the amount of tolerance of pressure, &c — Circumstances connected with the aneurism, its situation, size, and position with respect to the artery — Period at which the collateral circulation becomes established, phenomena which accompany it, ... ... ... 152