AN ADDRESS ON THE CATGUT LIGATURE 



Delivered before the Clinical Society of London, January 28, 1881. 

 [Clinical Society's Transactions, vol. xiw] 



Gentlemen. — In thanking you for the great honour which you have con- 

 ferred upon me by my election to this chair, I do so with a pecuhar feehng of 

 gratitude, because I am well aware that my personal share in the proceedings 

 of the Society has not been sucli as to entitle me to hope for so great a distinction 

 at your hands. I can only strive to discharge to the best of my abilit\- the 

 important duties which your kindness has imposed. 



In considering the choice of a subject for the inaugural address which is 

 expected from your President, I have felt myself precluded from presenting 

 a summary of the labours of the Society in the past, or from tendering advice 

 as to its conduct in the future, and, after consultation with some influential 

 members of the Council, I have decided to bring before you this evening a special 

 subject, w^hich wdll, I trust, be thought not unworthy of the occasion, inasmuch 

 as, while it is still in an unsettled or transitional state, it is full of interest for 

 every practical surgeon, and at the same time, in some of its aspects, well 

 deserves the attention of the pathologist and the physician — I refer to the 

 catgut ligature. In adopting this course I feel it needful to crave your indul- 

 gence ; for the subject is a large one, and, in order to do it anything like justice, 

 I shall have to trespass for a considerable time on 3^our attention. 



The catgut ligature has in some respects exceeded my original hopes. 

 I feared that its advantages would be limited to wounds in which putrefaction 

 was avoided, and that, if septic suppuration took place in a wound in which 

 it was employed for securing the vessels, the ligatures would, sooner or later. 

 come away like little sloughs. Such, however, has not proved to be the case. 

 Whatever be the progress of the wound, we never see anything of the catgut ; 

 so that even surgeons who have not adopted strict antiseptic treatment have 

 been led to employ the new material in ordinary wounds. Under other circum- 

 stances, however, the catgut has often led to disappointment. \\'e hear of 

 cases in which the Caesarian section has been performed, and all has gone on 

 well until the knots of the catgut with which the uterine wound was secured 

 have given way, and the patient's death has been the result. Again, in ligature 

 of large arterial trunks in tlieir continuity, several surgeons ha\'c met with 



