30 



SCIENCE 



[N. S. Vol. XXIX. No. 731 



Marcli 20, 1908, 5XVII., p. 473, is reported 

 the successful transplantation of a formalde- 

 hyde-fixed segment of blood vessel into a dog. 

 Since the work had been announced in 1907 in 

 the article referred to above, I did not con- 

 sider it necessary or even of interest to state 

 the date of the successful operation. Since 

 this appears to have been a mistake on my 

 part, I desire for the benefit of those in- 

 terested to here record it. My record shows 

 that the operation reported was performed 

 January 22, 1908. On February 12, 1908, the 

 neck was opened and the segment directly 

 examined. On February 29, 1908, the animal 

 was demonstrated before the St. Louis Medical 

 Society.* The manuscript of the note in Sci- 

 ence was mailed to the editor February 17, 

 1908. 



Levin and Larkin in Proceedings of the 

 Society for Experimental Biology and Medi- 

 cine, 1907-8, v., 109, also say: 



Carrel demonstrated that it is not only possible 

 to unite the two ends of a severed artery by a 

 suture but also to interpose between the cut ends 

 of it a segment of an artery of another animal 

 and perform a double anastomosis. The success 

 of the operation is due to the fine technique elat- 

 orated hy Carrel? 



The following quotations from a paper 

 entitled, " Uniterminal and Biterminal Ve- 

 nous Transplantations," by Carrel and 

 Outhrie (from the Hull Physiological Labora- 

 tory, University of Chicago), Surgery, Gyne- 

 cology and Oistetrics, March, 1906, U., pp. 

 266-77, will furnish those interested food for 

 thought : 



The transplantation of veins is a new operation, 

 and has been largely developed in this laboratory. 

 Therefore its history is short. 



In 1902, however. Carrel had shown that arterio- 

 venous anastomoses were possible, and considered 

 that all the transplantation of veins were feasible. 

 Our present results have entirely confirmed this 

 opinion. 



In 1905 we began experimenting in this labora- 

 tory* with the view, among others, of making a 



'^Interstate Medical Journal, XV., No. 6. 



'Tlie italics used in the above quotations are 

 my own. 



^ The work in this laboratory has been con- 

 jointly performed. 



complete study of the transplantation of veins. 

 Several series of experiments were undertaken in 

 order to study the results of the uniterminal and 

 biterminal venous transplantations, and they were 

 thoroughly successful. At this point we wish to 

 thank Dr. Stewart for his interest in this work 

 and his valuable suggestions, which have con- 

 tributed in no small degree to its success. 



In order, therefore, to successfully transplant 

 veins on to the arterial system, it was necessary 

 to have a technique permitting the union of the 

 vessels without hemorrhage or thrombosis. Be- 

 sides, positive results must be constant, for a 

 method is not satisfactory otherwise. In the first 

 experiments (1902), the technique employed did 

 not always yield good restdts. Thrombosis often 

 occurred. This was due mainly to the fact that 

 the delicacy of the endothelium of the vessels was 

 not appreciated. This led to a realization of the 

 fact that ordinary surgical methods are inade- 

 quate. The methods, for instance, which give 

 splendid results in abdominal surgery are much 

 too rough for use in vascular surgery. Xhe sur- 

 gery of the blood vessels is a new and special field, 

 and the operative handling must be delicately 

 adjusted and adapted to the nature and the reac- 

 tions of the tissues. 



According to these considerations, our technique 

 was improved by degrees. The threads and the 

 needles were the finest and the strongest obtain- 

 able. The threads were sterilized in vaseline, and 

 applied when heavily coated with the same. The 

 vessels were handled very gently, and the endo- 

 thelium was protected from drying by isotonic 

 sodium chloride solution or by sterilized vaseline. 

 No dangerous metallic forceps were used. The 

 greatest care was exercised to obtain accurate and 

 smooth approximation of the endothelium of the 

 vessels. Finally, we developed a technique which 

 is equally well adapted for arterio-arterial, veno- 

 venous, or arterio-venous anastomoses, and which 

 yields uniformly successful results. 



This new technique has been used since August, 

 1905. Numerous arterio-venous anastomoses and 

 transplantations of veins have been successfully 

 performed. Union of the walls of an artery and a 

 vein to each other may be made without the sub- 

 sequent occurrence of hemorrhage or stenosis. 



Modesty should prevent, but I am unable to 

 refrain from remarking in passing that it is 

 a singular fact that up till the time Carrel 

 and I engaged in the work together he re- 

 ported that his experiments did not always 



