86 A CASE OF LIGATURE OF THE BRACHIAL ARTERY 
afternoon the limb had already recovered its warmth and Mr. Burgess has since 
informed me that feeble pulsation was soon after perceptible at the wrist. In 
his last letter, written on the 21st of June, he stated that the ligatures had 
come away several days previously, the wound was healing kindly, and there 
was good sensation in the limb, though not quite so acute as in the other arm, 
while the patient was regaining health and strength. 
This case is an example of the practical application of the principles sought 
to be established in a paper lately published. in this journal,’ in which it 
was shown that tissues previously healthy retain their vitality for a much longer 
period than had been before supposed after complete withdrawal from the 
influence of the centres of circulation and innervation; and that by virtue 
of this persistent vitality the blood continues fluid for several days within the 
vessels of an amputated limb. In the present case the appearances of the arm 
and the previous history were such as would, I believe, have induced most 
surgeons not conversant with these principles to have resorted at once to 
amputation. 
* Vide a paper by the author ‘On Spontaneous Gangrene from Arteritis and the Causes of Coagula- 
tion of the Blood in Diseases of the Blood-vessels’. Edinburgh Medical Journal, April 1858 (p. 69 of 
this volume). 
