Surgical cases and observations / [Richard Carmichael].

  • Carmichael, Richard, 1779-1849
Date:
1818
Catalogue details

Licence: Public Domain Mark

Credit: Surgical cases and observations / [Richard Carmichael]. Source: Wellcome Collection.

    34/56 (page 32)
    lion of the saphena with the femoral vein ; the latter after this junction, completely emerges from under the artery, on the pubal side of which, it lies in the same plane, until both vessels are con¬ cealed from our view by Poupart’s ligament* If the pulsation of the artery is not so obvious as to direct us where to make our incision, we may err in approaching too near the pubis,and thus, (independent of other consequences) embarrass the subsequent steps of the operation, by opening the saphena vein ; but this may be avoided by measuring the distance between the symphisis pubis, and the most anterior point of the spinous process of the ileum. In middle sized male sub¬ jects this measurement usually gives five inches and a half, and in females half an inch or an inch more, one half of this measurement then brought to a transverse line from the upper edge of the symphisis pubis, will give the exact situa¬ tion of the ilial side of the artery, at the place where the ligafure is to be passed, which is at two inches and a half, or at the most three inches from this point along the groin towards the knee. In cutting down upon this spot, wTe come upon the pubal edge of the sartorius, where that mus¬ cle meets the artery, and here we have a strong dense fascia, (the fascia lata) extending from the muscle over the vessels, but it is considerably more dense over the latter $ this fascia may be