56 THE TONEU LECTURES. 



13th. If the blood-clot, during the first days of its formation, 

 become firmly adherent to the vessel-wall, the increase in the 

 size of the plastic clot causes granulations springing from it to 

 grow into the crevices and channels of the blood coao-ulum. 

 Through the continued invasion of the blood-clot by these 

 granulations, and their increase in thickness, the blood-clot 

 disintegrates in consequence of the gradually increasing pres- 

 sure, and is finally absorbed. See Fig. 6. 



14th. But if the blood coagulum form only slight connections 

 with the walls, the plastic clot, while iucreasinf in size durino- 

 the process of organization, gradually uplifts the blood-clot 

 and pushes the latter before it. In these cases, as late as the 

 twentieth day, when organization and vascularization have 

 been nearly completed in the plastic clot, not the slightest in- 

 dication of change, except that naturally due to the contrac- 

 tion of fibrin, is to l)e seen in the uplifted blood-clot. See Fig. 8. 



15th. If, in addition to the usual method of applying a liga- 

 ture, compression 'be produced upon the walls of the arter}^ a 

 short distance above the point of ligation, in such a manner as 

 to slightly rub together opposite points of the surface of the 

 internal limiting membrane witlrout rupturing the latter, and to 

 excite at that place an irritation, the plastic clot mainly forms 

 at that point instead of at the level of the ligature, and the 

 obliteration of the lumen of the vessel and the permanent 

 arrest of hemorrhage are more rapidl}- and more certainly se- 

 cured. A practical application of the same procedure to the 

 usual methods of performing acupressure may, a prio7-i, be ex- 

 pected to secure similarly good results. See Fig. 9. 



16th, The process of healing in an artery after limited tor- 

 sion has been performed is, in its essentials, identical with that 

 mentioned in the preceding paragraph. 



17th. The process of healing in an artery after acupressure 

 docs not essentially differ (except in its slowness) from that 

 which is usually seen after simple ligation has been done. In 



