-seilbe, healt a 
the tumor coagulating, it becomes firm to the touch. 
continuing to increase, at last becomes painful; the skin turr 
verging on mortification ; an oozing of bloody serum issues from 
. teguments ; and if gangrene does not take place, the skincracks in 
different parts; and now the force of the artery not meeting with 
much resistance, if the vessel is large, a period is soon put to the pa- 
tient’s existence, by the blood bursting out with apes violence as =g 
produce almost instantaneous death. ; 
In the larger arteries of the trunk, this is the common event of 
aneurisms. In the extremitites,. however, mes are more under es 
mand, and their effects not so fatal. ear —— 
~ In the earl éa-0f srne-aneuxiens;-ahias ee 
cbc ahiatinmsusiende pee ear om ea prevent 
ace increase of the tumor; and in some instances complete cures Boe 
have been made. But in the false aneu sm, where the blood isex- 
travasated into the parts, pressure should never be advised, as mor- 
tification might ensue. ; 
When the disease has become formidable, and other means fail, 
an operation of tying the artery becomes Roeaeay which i is genes Me 
this manner : :; 
The patient being properly placed and secured, and ‘the 
quet applied above, an incision is to be made with as ng 
the whole course of the tumor, through the cellular substance. The 
surgeon should now proceed in @ slow and cautious mannef, dis- = 
secting away one layer of membrane after another, till the arter 
self islaid bare. This being done, a lancet should be p 
the sac, so as*to make a hole large enough to admit the fing 
when a probe pointed knife should “be introduced on the finger, and 
the sac opened the whole length. The coagulated blood must now 
be taken out, together with all the other filaments, and the cavity — 
dried with a sponge, when the tourniquet should be made perfectly 
slack, in order to discover not only the artery, but the opening into 
it from whence the blood in the tumor has all along issued. This 
being done, we are next to employ means for prevents any, far- 
ther effusion of blood into the sac. 
The orifice of the artery being brought into view, a probe should 
be passed into it, to raise the artery from the contiguous parts, so that 
the surgeon may be enabled with certainty to pass a ligature around 
it without including the nerves, which in general run near the large 
blood-vessels of the limb. A firm waxed ligature, must now be 
passed round it, about.the eighth part of an inch above the orifice, 
and another at the same distance below.. The easiest method ‘of aoe 
introducing the ligatures, is by means of a blunt. curved needle. 
The ligatures both being passed, the upper one is now to be tied — 
aw firm for compressing the sides of the artery 5 not so tight, 
_ however, as to incur the risk of dividing it. 
_ Before the lower knot is tied, the ‘tourniquet sholigaiee untwi 
in order to see whether any blood is discharged by the ice 
ry ie not. if blood flows be will aflons a_ple 
