The first lines of the practice of surgery: designed as an introduction for students, and a concise book of reference for practitioners (Volume 1).

  • Cooper, Samuel, 1780-1848.
Date:
1822
Catalogue details

Licence: Public Domain Mark

Credit: The first lines of the practice of surgery: designed as an introduction for students, and a concise book of reference for practitioners (Volume 1). 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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    3ide of this tube; and on their arrival near the angle of the jaw, where they begin to give off their branches to the head and neck, they even lie rather behind the side of the larynx. Hence, we see the reason why a wound at the lower part of the neck is often very fatal, while one higher up is generally less dangerous. The suicide rarely strikes at the lower part of the neck, and it is from the accidental circumstance of his cutting very high up, near the chin, that the carotids escape. Secondly, as Mr. John Bell has explained, it should be remembered, that the carotid artery, the great jugular vein, and eighth pair of nerves, lie very closely connected with each other, being all inclosed in one mass of cellular substance, which forms a kind of common sheath for them. Now, says this author, since the eighth pair is one of the greatest nerves of the viscera, and since, from experiments on animals, we know that a wound of it is more fatal than a wound of the brain itself, this frequently puts an end at once to all questions about the way of managing wounds of the carotid artery, or of the great vein. No doubt, these may sometimes be partially wounded, and the nerve escape, but, in many instances, the nerve will be cut along with them; and at all events, the fatal consequences,which would arise from including this nerve in a ligature, make it absolutely necessary, that whenever the carotid is tied, it be first carefully separated from every other part.* That the internal jugular vein, or the carotid artery itself, may sometimes be partially injured, without the par vagum being also hurt, or the patient instantly perishing, has now been fully proved. I know of a case, which happened in the campaign in Holland in 1814, where the internal jugular vein was ruptured by the passage of a musket ball down the neck, and yet the patient lived more than an hour after the accident, and when he died, it was from suffocation, caused by the pressure of a large mass of extravasated blood upon the trachea. M. Larrey has related an instance, in which an officer received a gunshot wound, that cut the external carotid at its separation from the internal, yet the patient's life was saved by an intelligent soldier making immediate pressure on the vessel, and the subsequent employment of bandages.! Mr. Hennen also knew of an English officer, who was saved in India by the same means, from the effects of an arrow-wound of the carotid.J These cases * See John Bell's Discourses on Wounds, edit. 3. p. 415, f Mem. de Chir. Militaire, torn. i. p. 309 \ Obs. on Military Surgery, p. 180. vol. i. 68