MEMBERS OF THE BRITISH MEDICAL ASSOCIATION 269 



prepared catgut applied antiseptically. The opportunity of showing him to 

 you, I owe to my colleague Mr. Annandale, under whose care he has been. 



The case was one of aneurysm of the upper part of the femoral artery ; 

 but as it would not be right for me to anticipate Mr. Annandale in the publication 

 of its details, I shall merely mention to you the main point that I wish to illustrate. 

 The external iliac artery was tied under spray, the operation (at which I happened 

 to be present) being performed with strict regard to antiseptic management, 

 while the important matter of the use of drainage-tube was not neglected. 

 The operation w^as performed on the 23rd of June, and the wound was 

 absolutel}^ skin-whole in fifteen days, without the occurrence of any suppura- 

 tion at all. 



[Mr. Furneaux Jordan, of Birmingham, was now kind enough to come forward 

 and examine the patient, verifying the fact that there was no pulsation in the 

 artery at the groin. Mr. Lister then proceeded.] 



The immediate object of the operation has therefore been attained — the 

 vessel has been permanently obstructed at the part tied ; and this has been done 

 without the occurrence of any suppuration, and by a mode which, I think we 

 may venture to say, involves no danger whatever, provided it be properly 

 carried out. The two great risks of an operation like this are, of course, secondary 

 haemorrhage, and diffuse suppuration in the cellular tissue around the peritoneum; 

 and both of these are securely guarded against by proceeding in this manner. 

 I believe myself that this is a pretty perfect method of obstructing a vessel in 

 its continuity ; I do not see that we can wish to have it improved upon. I there- 

 fore regret extremely to find that it is still distrusted in various quarters, even 

 by those who use catgut for the ligature of arteries in ordinary' wounds. They 

 do not trust it for tying arterial trunks in their continuity. I regret this the 

 more, because I feel it is to a certain extent my own fault. When I first 

 published on the subject, I was not aw^are myself of the proper mode of pre- 

 paring the catgut. I had prepared it right, but by a mere accident. I described 

 the mode of preparation in the Lancet^ as steeping the catgut in a mixture of 

 carbolic acid and oil. It so happened that the carbolic acid whicli I used was 

 liquid carbolic acid, so called — that is to say, cr3'stallized carbolic acid, liquefied 

 by the addition of water. Now, this water makes all the difference in the world. 

 When oil is added to this liquid carbolic acid, a considerable portion of the 

 water is deposited in the form of very fine particles, which arc suspended in the 

 oil ; and it is this mixture — this emulsion if we ma}^ so call it — of oil and water 

 which causes the remarkable physical change in the animal tissue of which 

 catgut is composed, that alone renders it fit for our objects. The tissue of the 



' See Lancet, April 3, 1S69 (p. 86 of this volume). 



