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there is no subject which, it more gratifies your committee to notice, 

 than that of the treatment of aneurism by compression. Compres- 

 sion of the vessel between the aneurismal tumour and the heart, it 

 is well known, was long ago employed, and examples of true aneurism 

 of the lower extremity, radically cured by this means, are recorded ; 

 yet as the principle on which the treatment should be conducted 

 was not then understood, much distress was occasioned by it, many 

 failures occurred, and the practice fell into disuse. Scarpa emitted 

 the opinion that it was by exciting adhesive inflammation in the in- 

 ternal coat of the vessel, that pressure effected the cure, and the 

 same doctrine was afterwards held by our own experimenter, Jame- 

 son ; but the recent and accurate observations of the Dublin sur- 

 geons , particularly of Mr. Bellingham, show that obliteration of the 

 vessel by its inflammation and consequent effusion of lymph is not 

 requisite for the cure, and have, as we think, satisfactorily proved, 

 that for the cure of aneurism by compression above the sac, an 

 absolute interruption to the circulation through the vessel is not de- 

 manded — the process of cure, when it occurs, being identical with 

 that by which nature sometimes spontaneously effects it; viz., the 

 gradual deposition of the fibrine of the blood in the sac until it is 

 completely filled up, and no longer permits the entrance of that 

 fluid. The practical deduction from this principle is, that the pres- 

 sure need not be so great as entirely to interrupt the circulation at 

 the point compressed, and that in fact our object may be attained 

 by simply diminishing the current, and thus favouring the deposit. 



In 27 cases, which are related in the valuable communication of 

 Mr. Bellingham, from the practice of seventeen surgeons, 24 were 

 cured. One died suddenly from disease of the heart, forty-eight 

 hours after pressure had been removed, all pulsation in the aneurism 

 having ceased. In another case the operation was done at the 

 request of the patient after the pressure had been continued for a 

 fortnight, and in the third, pulsation continuing some time after 

 compression was resorted to, a galvanic current was passed through 

 the sac, and was followed by erysipelas and death. 



The ages of the patients operated on, varied from twenty-three 

 to fifty-five years. The greatest length of time required for the 

 cure in the above 24 cases was 106 days; the shortest, two days. 

 The average duration of treatment was nearly 39 days. Of the 

 whole number of cases, three were femoral, and the rest popliteal 

 aneurisms, and the case followed by death, as well as those in which 

 the treatment failed, belonged to this latter class. 



