A case of amputation at the shoulder-joint / by E.R. Peaslee.

  • Peaslee, E. R. (Edmund Randolph), 1814-1878.
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: A case of amputation at the shoulder-joint / by E.R. Peaslee. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    viously. Soon afterwards the pulse and temperature of the surface began to rise, and at half-past 5 o'clock the operation was performed, with the assistance of Drs. Lincoln and Ellis, and Dr. J. B. Upham, now of Boston. The reaction had been promoted by dry fomentations and the administration of lauda num; which had been so frequently given that he had taken not less than one ounce during the time which had elapsed between the accident and the operation—as I afterwards ascer- tained. None but the best effects, however, ensued; his pre- vious habits having been (as his medical attendants under- stood,) such as to render him not a stranger to the effects of stimulants. So much of the soft parts near the shoulder had been re- moved, as has been seen, that only a very small and irregular anterior flap could be formed. The parts also which were needed for a posterior flap were blown out so extensively as not to allow the formation of a flap sufficiently wide to cover tlje lower part of the wound in that direction. And yet the flaps must be anterior and posterior, so far as the material to form them might be obtained. Acatlin was therefore passed through from the inner edge of the deltoid, at a point two inches below the joint, and out at the edge of the external wound, and a very small anterior flap was thus made. The knife was then carried through the joint, and a posterior flap made of the skin and triceps muscle, extending nearly half way to the elbow. This flap, however, was barely long enough to meet the other in the middle, and was so narrow at the part opposite to the two openings made by the passage of the charge, and where so much skin and muscle had been carried away, that only about three-fourths of the whole wound left after the extremity was removed could be closed and covered, on adjusting the flaps in the best possible manner. The subclavian artery was compressed by Dr. Ellis during the operation; and about four ounces of blood were lost. No anesthetic was used, except the laudanum; as Dr. Morton's discovery was not made till more than a year subsequent to this time. About one-fourth of the wound was left uncovered, for the reason before mentioned, on adjusting the flaps as well as