OF TREATMENT IX SURGERY 63 



the mechanical result of the injury. But, thirteen days after the accident, 

 profuse haemopt^'sis appeared, which I was disposed to attribute to tearing 

 open of the wound in the lung through his imprudent exertions ; and this, 

 continuing for several days, threatened entirely to exhaust his weakened frame. 

 The expectorated blood assumed also a putrid odour, like that from gangrene 

 of the lungs ; and I was apprehensive that the putrescence might spread to 

 the mass in the pleura. Fortunately, however, this did not occur. The bloody 

 expectoration gradually became purulent, and then diminished in quantit\' till 

 it ceased entirely. With regard to the external wound, it furnished no pus so 

 long as the original mode of dressing was continued. In the first twenty-four 

 hours, there was a free discharge of bloody serum ; but this grew less from 

 day to day, till, six days after the receipt of the injury, it amounted to less 

 than a minim in forty-eight hours ; and when the piece of lint, which had been 

 kept permanently on the wound beneath the paste, was removed, between 

 three and four weeks after the accident, a superficial sore was found, which 

 afterwards cicatrized kindly. On the i8th of November, seven weeks after his 

 admission, the apex of the heart was observed to be again beating below the 

 left mammilla ; and, finalh', I ma}' add, that he was seen a few da^-s ago b\' 

 Mr. Cameron, engaged with another butcher in driving a herd of unruly cattle 

 through the streets, when our former patient, though still pale from anaemia, 

 proved the more vigorous of the two in turning the animals ; while his lusty 

 exclamations, though not couched in the most decorous language, gave satis- 

 factory evidence of the soundness of his lungs. 



Ligature of Arteries. 



I have now to show you a preparation illustrating the effects of the applica- 

 tion of a ligature upon an artery on the antiseptic system. The theory of such 

 a procedure is simple. A foreign body introduced among the tissues does not 

 exert any disturbing influence upon them, unless it be either mechanically or 

 chemically irritating. Thus, it is well known that a needle or a spiculum of 

 glass may lie for an indefinite period embedded in the living textures without 

 inducing suppuration ; and any irritation which may result is due simpl\- to 

 the rigidity and form of the foreign solid. Now, a bit of silk or linen thread 

 being composed of materials of soft consistence and as unstimulating chemicall\' 

 as glass or steel, its presence among the tissues cannot of itself occasion an\ 

 disturbance. But, unUke the glass or metal, the thread is porous, and contains 

 in its interstices putrefactive germs, which, developing in the serum that bathes 

 the ligature, give rise to the acrid products of decomposition, and these, in their 

 turn, stimulate the surrounding tissues to granulation and suppuration. It. 



