Note 43 — PART SECOND. OF PARTICULAR SURGICAL SUBJECTS. (continued 6)

[I had occasion last winter to tie the humeral artery, for a wound inflicted upon it in bleeding at the bend of the arm, in a youth eighteen years of age, from one of the border counties of this state. The accident had occurred about six weeks previously with a thumb-lancet. It was soon followed by great swelling and discoloration of the limb, which gradually extended downwards nearly to the middle of the forearm and upwards as far as the axilla. The pain was excessive, the appetite much impaired, the sleep constantly interrupted, and the countenance blanched and expressive of great suffering. About the fourth week a large opening formed at the seat of the original orifice, from which upwards of a quart of thick grumous blood was discharged. He was brought to town on the 27th of December, and placed under the care of my friend, Dr. Drane. At this time his health was frightfully deranged; his strength was much exhausted; he had not slept for several nights; and the whole limb, benumbed and excessively painful, was swollen from the wrist to the shoulder. The parts pitted under pressure, two small foul-looking ulcers existed at the bend of the arm, the skin was discoloured, and fluctuation could be distinctly felt all the way up from below the elbow to the insertion of the deltoid muscle.

With the assistance of Dr. Drane, an incision, five inches in length, was made over the course of the humeral artery; and after much difficulty, owing to the confused state of the parts, a ligature was placed above and below the orifice, which was found to be at least six lines long! All the grumous blood, amounting to nearly a quart, was squeezed out, when the edges of the wound were brought together with adhesive strips and a roller extending from the wrist upwards. Very little sloughing took place; and, notwithstanding the exhausted condition of the patient at the time of the operation, he made a very speedy recovery.—ED.]