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What happens to the Brachial artery......?

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  • Michael
    In looking at some resources relating to arm amputations and amputations in general I am confused as to some aspects of how this procedure was handled in the
    Message 1 of 3 , Oct 6, 2008
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      In looking at some resources relating to arm amputations and
      amputations in general I am confused as to some aspects of how this
      procedure was handled in the 18th. century...

      Take an above-the-elbo amputation for instance: If the screw tourniquet
      is securely screwed down, how is the brachial artery approached? Is it
      sought with a separate, controlled incision to locate it and tie it off?
      I would guess it might retract if simply cut with the muscle without
      tie-off, and then spurt blood uncontrollably while it withdrew putting
      the patient at greater risk of shock and death. Could somebody please
      clarify this handling of the brachial artery? If somebody knows a "step
      by step" procedure id be much obliged. This is a facinating subject
      which I plan to delve deeply into.....Thanks..Mike/Brooklyn
    • Ed St.Germain
      On Oct 6, 2008, at 3:38 PM, Michael mikeeeebx@yahoo.com wrote: I am confused as to some aspects of how this procedure was handled in the 18th. century...
      Message 2 of 3 , Oct 7, 2008
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        On Oct 6, 2008, at 3:38 PM, "Michael" mikeeeebx@... wrote:
        I am confused as to some aspects of how this procedure was handled in
        the 18th. century...

        Michael:

        "There is no Method for this Purpose so secure, as taking up the
        Extremities of the Vessels with a Needle and Ligature in the
        following Manner. As soon as the Amputation is performed, the
        Assistant must loosen the Tourniquet for a Moment, upon which the
        Orifices of the Arteries will appear by the Issue of the Blood. The
        Operator having then fixed his Eye upon one of the largest Vessels,
        passes a crooked Needle thro' the Flesh, a little more than a quarter
        of an Inch above the Orifice, and about the same Depth, in such a
        Direction, as to make nearly one third of a Circle round the Vessel:
        then withdrawing the Needle, he a second time passes it into the
        Flesh and out again, in the same Manner and about the same Distance
        below the Orifice of the Vessel: By this means, the Thread will
        almost encompass the Vessel, and, when it is tied (which should be
        done by the Surgeon's Knot) will necessarily inclose it within the
        Stricture. All the considerable Arteries are to be taken up in the
        same manner; that is, the Tourniquet is to be loosened in order to
        discover the Vessel, and then the Needle is to be passed round it as
        I have here described This is a much better Way than using the Artery
        Forceps where the Vessels are apt to slip away out of the Ligature;
        and as to styptick Applications, their want of Safety is so well
        known now, that the Use of them, in Hæmorrhages from large Vessels,
        is almost universally rejected; though it is thought by several
        Surgeons who have experienced the Virtue of Agaric, that it will be
        found to be a more powerful Astringent than any hitherto discovered."

        From: http://www.americanrevolution.org/surgery/surgery37.html

        While the above discussion is of leg amputations, it is just as
        applicable to arms.

        I was once taught that aboard ship, the stump would be dipped in a
        bucket of hot pine tar, but I've never found any primary sources for
        that proposition. That was when I was in the Navy, and was supposedly
        the reason 18th century corpsmen were called "loblolly boys" after
        the loblolly pine from whence the tar came.

        Best regards,
        Ed St.Germain
        Patriot1@...
        for Revolutionary War information on the internet, your first choice
        should be AmericanRevolution.org
      • Michael Littlejohn
          Thank you very much for that Ed..that hit the spot.....Mike ... From: Ed St.Germain Subject: [Physick18C] Re: What happens to the
        Message 3 of 3 , Oct 7, 2008
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          Thank you very much for that Ed..that hit the spot.....Mike

          --- On Tue, 10/7/08, Ed St.Germain <patriot1@...> wrote:
          From: Ed St.Germain <patriot1@...>
          Subject: [Physick18C] Re: What happens to the Brachial artery......?
          To: "Physick" <Physick18C@yahoogroups.com>
          Date: Tuesday, October 7, 2008, 1:21 PM

          On Oct 6, 2008, at 3:38 PM, "Michael" mikeeeebx@yahoo. com wrote:
          I am confused as to some aspects of how this procedure was handled in
          the 18th. century...

          Michael:

          "There is no Method for this Purpose so secure, as taking up the
          Extremities of the Vessels with a Needle and Ligature in the
          following Manner. As soon as the Amputation is performed, the
          Assistant must loosen the Tourniquet for a Moment, upon which the
          Orifices of the Arteries will appear by the Issue of the Blood. The
          Operator having then fixed his Eye upon one of the largest Vessels,
          passes a crooked Needle thro' the Flesh, a little more than a quarter
          of an Inch above the Orifice, and about the same Depth, in such a
          Direction, as to make nearly one third of a Circle round the Vessel:
          then withdrawing the Needle, he a second time passes it into the
          Flesh and out again, in the same Manner and about the same Distance
          below the Orifice of the Vessel: By this means, the Thread will
          almost encompass the Vessel, and, when it is tied (which should be
          done by the Surgeon's Knot) will necessarily inclose it within the
          Stricture. All the considerable Arteries are to be taken up in the
          same manner; that is, the Tourniquet is to be loosened in order to
          discover the Vessel, and then the Needle is to be passed round it as
          I have here described This is a much better Way than using the Artery
          Forceps where the Vessels are apt to slip away out of the Ligature;
          and as to styptick Applications, their want of Safety is so well
          known now, that the Use of them, in Hæmorrhages from large Vessels,
          is almost universally rejected; though it is thought by several
          Surgeons who have experienced the Virtue of Agaric, that it will be
          found to be a more powerful Astringent than any hitherto discovered."

          From: http://www.american revolution. org/surgery/ surgery37. html

          While the above discussion is of leg amputations, it is just as
          applicable to arms.

          I was once taught that aboard ship, the stump would be dipped in a
          bucket of hot pine tar, but I've never found any primary sources for
          that proposition. That was when I was in the Navy, and was supposedly
          the reason 18th century corpsmen were called "loblolly boys" after
          the loblolly pine from whence the tar came.

          Best regards,
          Ed St.Germain
          Patriot1@AmericanRe volution. org
          for Revolutionary War information on the internet, your first choice
          should be AmericanRevolution. org

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