Former interns of the Homoeopathic Hospital, Ward’s Island, and students from the colleges may remember the ligature of the femoral artery in its middle third for the cure of a large popliteal aneurysm, which was done at the hospital January twenty-ninth, 1891. The case was reported at the following June meeting of the International Hahnemannian Association. These excerpts from the report are pertinent to our subject, as the trouble prescribed for was a traumatism of the minute nerves which supplied the artery:
“Our antiseptic friends would probably not approve of the course that was followed, as we relied upon simple cleanliness, as usual, all through the operation, it being in a large, full hospital. The artery was found in the sheath with the vein and in front of the vein instead of behind it. This anomaly is unique, so far as I can learn. Well waxed, braided silk, No. 5 size, was tied tightly around the artery, and one end left hanging outside the wound, the other cut short. Were the operation to be repeated by me today, both ends would be cut short. The wound was carefully rinsed with dilute calendula, dried, the sides approximated with ordinary, interrupted sutures, and covered with dry, unmedicated cotton. The hospital record of what followed reads thus:
‘Patient rallied, but in the evening, about seven o’clock, he suffered excruciating pain. The doctor gave him seven-eighths of a grain of morphine and other drugs, but the pain kept increasing. At eleven p. m. he could stand the pain no longer; and upon consultation of staff, an amputation was deemed necessary. So Doctors Breck and Miller went to the city for Dr. Carleton’s consent to operate. But Dr. Carleton, after getting the patient’s symptoms from the doctors, decided to prescribe instead of amputate, and said if pain did not cease he would amputate in the morning. He sent Coffea cruda., two hundredth, a few pellets to be put upon the tongue every fifteen minutes until pain should abate and patient slept soundly.” [After the second dose he went to sleep and never received the third dose.]
“When he awoke the pain was nearly gone and he was feeling well in all respects.
Dr. Carleton was notified in the morning of good recovery and he did not deem it necessary to come over. The temperature at eleven p. m., when the doctors went to the city, was 104; at four A. M., January thirtieth, it was 102; at eight a. m., 101.3.
The temperature ranged from 99.4 down to normal and stayed there. Wound healed by granulation. Very little pain at times. Recovery was all that could be looked for.
“The hospital narrative may be amplified a little. The seven-eighths of a grain of morphine had been followed by a huge dose of bromide, and that by a large dose of chloral, and that by three ounces of whiskey. None of these made any apparent impression on the case. The patient screamed and tossed and wanted to throw himself out of the window. The symptoms that led me to select Coffea cruda were ‘pains seemed insupportable, driving to despair;’ ‘ great nervous agitation and restlessness.’ These tally exactly with Hering’s Materia Medica. Besides, patient complained of ‘arterial tension, twisting and wrenching, where the ligature had been applied, and running thence up to the heart and brain,’ which corresponds pretty fairly with Hering’s Symptoms : ‘strong, quick palpitation of the heart with extreme nervousness, sleeplessness and cerebral erethism.’
“The stitches came away with a little pus. The ligature came away March eleventh, the fortieth day after its application.”