94 OBSERVATIONS ON LIGATURE OF ARTERIES 



germs in with it. The external dressing was a towel saturated with the oily 

 solution, folded as broad as the length of the neck, round which it was wrapped 

 so as to extend freely beyond the wound in all directions, prevented from slipping 

 backward and forward by being stitched to a halter round the head, and to 

 a girth behind the forelegs, while a bandage rolled round it kept it applied accu- 

 rately to the surface. A sheet of gutta-percha tissue, to prevent contamination 

 of the antiseptic towel from without, and another roller, completed the dressing ; 

 and a * cradle ' was placed upon the neck to check lateral movements which 

 might disturb it. I have described these particulars because I am more and 

 more convinced of the necessity for scrupulous attention to details such as 

 the germ theory dictates, in order to attain anything like uniformity of 

 successful results. 



A few ounces of the oily solution were poured daily over the towel for the 

 first week, after which the dressings were left untouched for three days, and 

 then entirely removed. The wound was found quite dry and free from tender- 

 ness, and the cloth showed only a superficial bloody stain. The stitches being 

 taken out, a drop of pus escaped from the track of the suture next the head ; 

 but this was the only appearance of suppuration in the case from first to last, 

 and on the separation of the scab, a few days later, a sound cicatrix was disclosed. 

 A month (thirty days) after the operation the animal, which had continued in 

 perfect health, was killed, and the soft parts of the neck below the spine were 

 removed for examination. On dissection I was struck with the entire absence 

 of inflammatory thickening in the vicinity of the vessel, the cellular tissue 

 being of perfectly normal softness and laxity. On exposing the artery itself, 

 however, I was at first much disappointed to see the ligatures still there to all 

 appearance as large as ever. But had I borne in mind what I had observed 

 in some of my earlier cases of compound fracture treated antiseptically, I should 

 have been prepared to find these threads present in appearance, though absent 

 in reality. It may be well for me to quote from the account I have before 

 given of one of these cases.^ It was a compound fracture of the leg, produced 

 by direct violence, with a wound of considerable size, and a great deal of extra- 

 vasation of blood into the limb. In accordance with the practice which I then 

 followed, a piece of lint soaked with undiluted carbolic acid had been placed 

 over the wound, and had formed with the blood a firm crust. ' Nearly three 

 weeks after the accident I was detaching a portion of the adherent crust from 

 the surface of the vascular structure into which the extra vasated blood beneath 

 had been converted by the process of organization, when I exposed a little 

 spherical cavity about as big as a pea, containing brown serum, forming a sort 



^ See Lancet for March 16, 1867, p. 328 (p. 8 of this volume). 



