366 SURGERY 



vessel by this procedure. The internal iliac was first successfully tied 

 for the cure of an aneurism by Stevens, in 1812, and again success- 

 fully by Mott, in 1827, and by White, in 1847. The two internal 

 iliacs were first tied simultaneously for the cure of double gluteal 

 aneurism by Dennis, in 1886, upon a patient belonging to Dr. Car- 

 penter, of Boonton. In this case a laparotomy was performed as a 

 preliminary step. The same operator has since tied successfully the 

 internal iliac for the cure of gluteal aneurism, for the first time, by 

 laparotomy, as a preliminary step to operation. The external iliac 

 was tied successfully in 1811, by Dorsey, and again successfully by 

 Post, in 1814. Onderdonk, in 1813, tied the femoral artery suc- 

 cessfully for acute phlegmonous inflammation of the knee-joint, and 

 Rodger did the same operation with success in 1824. Carnochan, in 

 the year of 1851, tied the femoral artery for the first time for the 

 cure of elephantiasis arabum, thereby inaugurating a new principle 

 of treatment. In addition to the various ligations already mentioned 

 for the cure of aneurism, the invention of a variety of compression, 

 known as digital pressure, was carried into practice by Jonathan 

 Knight, of New Haven, in 1848. 



There are many modifications of digital pressure. Wood utilized 

 the bag of shot which was suspended above the patient, and by this 

 means the pressure was effected by it instead of by the finger. In 

 1874 Stone of New Orleans first cured a traumatic aneurism of the 

 second portion of the subclavian artery by digital pressure upon 

 the third portion of the vessel. Martin, in 1877, suggested the use of 

 the elastic bandage in the treatment of varicose veins, and recently 

 Phelps, the method of the multiple ligature of the veins from the 

 . ankle to the saphenous opening. He applies some 60 ligatures to the 

 limb, and the results of his operations have been most satisfactory. 



There has been much diversity of opinion as to whom the credit 

 belongs for the introduction of the Esmarch bandage. In the public 

 clinics of the Jefferson Medical College, at the time of an amputation, 

 the limb was rendered bloodless by elevation of it, and by the appli- 

 cation of a roller bandage to it by the elder Pancoast and Gross. This 

 was done before a tourniquet was applied. The value of this pro- 

 cedure was not published, and to Esmarch is due the credit of having 

 adopted the principle with the modification of the elastic bandage, 

 and having published it abroad for the benefit of the profession. 



In the surgery of the nerves the work performed by Americans is 

 most commendable. In 1856 Carnochan excised the second branch 

 of the fifth cranial nerve beyond Meckel's ganglion for the relief of 

 tic douloureux, and two years later Pancoast performed the same 

 operation in the pterygomaxillary fossa. The mortality of the Kraus- 

 Hartley operation for the relief of tic douloureux by removal of the 

 gasserian ganglion in 108 cases collected by Tiffany was 22.2 %. In 



