VIVISECTION AND PRACTICAL MEDICINE. 621 



soft bands were tied lightly on it. This fact hardly gained the uni- 

 versal and complete confidence of surgeons until further vivisections 

 performed by Lister, Briicke, and others, showed that the smooth lin- 

 ing of the vessel was the chief factor in preventing coagulation, and 

 that intravascular clots are formed most readily when the lining of 

 the vessel was injured and the blood ceased to move. Instead of 

 timidly tying a loose knot for fear of injuring the vessel, the surgeon 

 now ties a firm ligature so as to rupture its lining coat, or at least to 

 apply sufficient pressure to cut off its nutrition and thus cause its death 

 in order to make a starting-point for the coagulation which must occur 

 to secure its permanent closure. 



Another great objection to the old ligatures was the delay they 

 caused in coming away. This wearied the surgeon and exhausted the 

 patient. The ligature was sometimes pulled away before its time, and 

 this often gave rise to the much-dreaded secondary haemorrhage. In 

 counseling that the ligature be left alone, Petit adds the remark, as a 

 kind of consolation, that he finds them generally to come away of 

 themselves in about two or three months. Of this sort of annoyance 

 we hear nothing now. Experiment on the lower animals has taught 

 us the existence of the lymphatics and their absorbing power. Ex- 

 periments upon living animals has shown us that this power of absorb- 

 ing extends to such things as catgut, a material readily made into 

 strong cords. Properly prepared catgut is, therefore, almost univer- 

 sally used as a ligature, the ends are cut off short, and the knot is left 

 to be absorbed, and never once thought of again. 



And, lastly, the edges of the wound are brought together with 

 stitches of silver wire, silk, catgut, horse-hair, according to whether 

 much or little traction or more or less coaptation is demanded. Un- 

 due tension, compression, gaping, and irregularity of the wounded 

 part, are all avoided ; a means of exit for serous oozing, etc., is pro- 

 vided by non-irritating drainage-tubes. The antiseptic dressings are 

 applied carefully and exactly. Large tents, dossils of lint, rude com- 

 presses are not thought of. The aseptic wound heals without swell- 

 ing or inflammation. No throb disturbs the patient's rest. No drop 

 of pus comes from the cut surface. Fever, tetanus, pyaemia, second 

 haemorahage, as well as the old dread of the bleeding during the oper- 

 ation, are all nearly forgotten. 



To the minds of the surgeons of the last century such a method of 

 operation and such a mode of healing would probably suggest the 

 longed-for magic remedies by means of which many hoped to replace 

 the cauteries, caustics, compresses, and filthy dressings with which they 

 strove to heal the open w T ounds of their exhausted and cachectic 

 patients. Lancet. 



