Natural History. 429 



it by a spring ; then applying more or less force, the artery is to be 

 drawn until five or six lines in length have been separated from the 

 flesh ; then, by means of a second pincers, the surrounding tissues 

 are to be forced upwards or downwards, so that the artery shall be 

 perfectly isolated from the nerves and other soft parts, which might 

 have been laid hold of with it. That done, a rotatory movement 

 is to be impressed on the artery by revolving the pincers between 

 the fingers, and this is to be continued until the portion held by the 

 instrument is broken ; the haemorrhage will then be arrested. When 

 an artery is to be twisted, it is well to fix it between the finger and 

 thumb of the left hand, and then four or five turns will be sufficient 

 to break it. When it is left free, the torsion extends up it to the 

 next branch, more turns are required, and the operation prolonged. 

 When the twisted artery is left to itself, it becomes tense and vibrates 

 in accordance with the pulse; when dissected, the twisted part is 

 found to be solid, and the inner coats are found to be broken, as 

 in the application of a ligature ; but besides they are puckered, 

 and form a sort of cul-de-sac, or valve, against which the blood 

 presses. 



M. Amusat has made many experiments upon this mode of 

 closing arteries, with great success. He has applied it twice in 

 human beings ; once in a case of amputation at the knee, and once 

 in a case of extirpation of the testicle; in both it was perfectly suc- 

 cessful. In his experiments upon dogs, he has tied the crural artery 

 on one side, and twisted that on the other : two of the animals died 

 from haemorrhage occurring on the side where the ligature had been 

 applied. One advantage urged by M. Amusat in favour of the 

 process is, that the artery is always operated upon free from the 

 nerves and neighbouring parts, whilst ligatures often inclose these 

 parts and produce serious evils ; he adds, also, that ligatures are 

 rarely drawn tight enough, or well practised. He thinks that the 

 process may be substituted, with advantage, for that of tying; 

 i. Because it is simpler ; ii. Because a single person can do it, 

 requiring no assistance — an advantage of great importance in 

 pressing cases, either in the country, or in battle ; iii. 3ecause it 

 offers great advantages in the immediate re- union of the parts 

 affected. 



M. Amusat's process has, however, been very much canvassed, 

 and opposed by other members of the Academy ; some stating that 

 it was difficult of performance, and occasionally dangerous ; others 

 that it was old, and others that M. Amusat's observations upon the 

 process of tying were not correct. — Bull. Univ. C. xviii. 459. 



14. On Metallic Ligatures applied to Arteries. — Mr. Lerut has lately 

 been led to ascertain the value of a suggestion thrown out some 

 years ago by Dr. Physick, of using leaden ligatures. The idea arose 

 from considering, that in numerous cases, bullets, buck-shot and 

 lead, would remain in contact with almost any tissue of the body, 



2 F 2 



