Arteriotomy, ἀρτηριοτομία, from ἀρτηρία [arteries], and τέμνω, I cut , a surgery → term, the operation of opening an artery, or of drawing blood by opening such a blood vessel with a lancet, which is practiced in some extraordinary cases. See Artery, Phlebotomy, etc . See also Aneurysm .

The arteriotomy is an operation that is only practiced on the forehead, at the temple, and behind the ears, because of the skull which serves to support the arteries; everywhere else the opening of an artery is ordinarily fatal: there are a great number of examples of people who have died from being bled because an artery was mistaken for a vein. [1]

Fernel ( 2. 18 ). Severinus ( Efficaci medicinae part. II. ), Tulpius ( observationes, I. 48. ) and Catherwood have made efforts to introduce arteriotomy for apoplexy cases, as being preferable to bleeding from the veins, but few have followed their ideas. [2] See Apoplexy .

To open the temporal artery, which is the one preferred for arteriotomy , do not apply a ligature; feel for one of the branches with the index finger; secure the branch with the left thumb; open it the same way as a vein in phlebotomy; some prefer the use of a scalpel. The blood that comes from the artery is crimson and comes out in spurts, which corresponds to the action of the covering membranes of arteries. When the desired amount of blood is drawn, bind the opening of the wound, and cover it with three or four segments of compression gauze, of which the first should be one square inch in size, and the others should be larger in proportion, so that the compression is tight. Hold these compresses with a bandage called solar ; here is how it is done; take a strip four ells long and three fingers wide;  [3] roll it into two bundles, take one in each hand. Apply the middle of the solar strip to the compression gauzes to go around the head at the temple, bind the two ends when switching the bundles between hands; return them to the compression gauzes, where they should be crossed when changing hands, so that if it is on the right side, pass the posterior bundle under the anterior one, which is the one passed over the forehead, and which in the proposed example is held by the right hand. As soon as you have changed hands, place one on top of the head and the other underneath the chin; continue by crossing them on the temple opposite from the one with the wound, to change hands around the head for a second packing knot underneath the compression; continue to make tight circles around the head with the rest of the strip. See Surgery → Plates, Pl. XXVII, fig. 3 . A well-produced circular bandage is just as effective without as much inconvenience. [4]

It is arterial wounds that produce dangerous hemorrhages. In the article Hemorrhage, different methods invented by practitioners [ l’Art ] to stop them are discussed. One cannot deny that ligature is the safest of them all: however, there are cases where it has significant disadvantages, such as in that of an aneurysm in the arm; since the surgeon is never certain to not tie the trunk of the artery, the patient is at risk of losing the arm through the effect of the ligature, if there is not another alternative for the circulation of blood other than the tied artery. Thus, it is a great remedy, that which is applied to the arterial wound revealed by an incision, stops the blood, and makes the ligature unnecessary. The king has just bought it ( May 1751 ) from Sir Brossart, Surgeon of La Châtre in Berry, [5] after several experiments with amputations done at the Royal Hospital of the Invalides and at the Charity Hospital [in Paris], but notably after an aneurysm healed by this method, and conducted by the noted M. Morand, of the Royal Academy of Sciences. This celebrated surgeon, whose love for public welfare equals his talents and knowledge that are so widely acknowledged, graciously shared with us the remedy in question.

It consists of the fungal substance of the plant named agaricus pedis equine faice ( Institutiones rei herbariae, 562. Fungus in caudicibus nascens unguis equine figurâ. C. B. Pin. 372. Fungi igniarii. Trag. 943) because amadou is made from it. [6]

Cut the woody bark of this agaricus; separate the fungal part from the rest of the plant; it is supple like the skin of a chamois; soften it further by beating it with a hammer. A piece of this species of amadou applied to the arterial wound, and larger than said wound, supported by a slightly larger second piece, and by an appropriate bandage, stops the blood.

Notes

1. On the medical practice of bloodletting, which originated in ancient times and continued to be practiced into the nineteenth century, see “A Brief History of Bloodletting.”

2. Jean-François Fernel (1497-1558) was a professor of medicine and author of several books on the subject; Marcus Aurelius Severinus (1580-1656) was the author of Efficaci Medicina (Frankfort, 1646); Nicolaes Tulp (1593-1674) was a Dutch surgeon and the author of Observationes medicae; John Catherwood was the author of A New Method of Curing the Apoplexy (London, 1715).

3. An ell ( aune in French) is a unit of measure approximately the length of a man’s arm from the elbow to the tip of the middle fingers. The length of an ell was different in different countries; in France, an ell was approximately 54 inches or 137.2 cm. See Units of Measurement in France before the French Revolution.

4. Antoine’s text ends here. The remainder of the article was written by Diderot, as indicated by an asterisk (*) placed at the beginning of the next paragraph.

5. Berry is a region in the center of France.

6. The reference is to Joseph Pitton de Tournefort, Institutiones rei herbariae (1719), p. 562.