74 VETERINARY SURGICAL THERAPEUTICS. 
the finger or a ball of cotton the part where the blood vessel is 
situated. It is rarely sufficient to produce definitive hemostasis. 
When the operation is ended, other hemostatic means must be used. 
Cauterization of raw surfaces and of vascular stumps is hemostatic 
only by making a more or less thick scab, great inflammation, and 
abundant suppuration. 
Ligating of Blood Vessels is made with silk threads or catgut. In 
excisions, when a visible and isolated artery has to be divided; two 
ligatures are applied upon it, between which the cutismade. Ifthe 
blood vessel—artery or vein—is divided by accident, the ends are 
secured with forceps or a tenaculum and tied up with a straight 
knot. Constriction made upon an artery has the effect of dividing 
its middle and internal coats, which, curving inwards in retracting, 
close its mouth. The external wall shrinks, rests upon itself, and 
does not give way for several days later. When catgut is used, the 
ends of the ligature can be cut close to the knot; with silk thread 
only one of the ends is cut close to it, the other is brought outside 
of the wound, to be pulled away with the rest of the thread when 
the division of the blood vessel is complete. Hemostatic forceps 
with broad jaws, conical or cylindro-conical, are very handy to 
make these vascular ligatures. It is to immediate ligature that one 
must give preference. In the cases where that is impracticable, 
where the ends of the vessel are concealed deeply in the tissues, and’ 
difficult to find, mediate ligature is resorted to. With a curved 
needle, a thread is passed round the blood vessel and the soft tissues 
surrounding it, and is secured with a straight knot. 
Torsion, recommended by Amussat and more recently by Tillaux, 
may take the place of ligature for arterioles and veins of small 
caliber. With forceps, the bleeding stumps are taken hold of, gently 
drawn out of the tissues and twisted. The wdlimited torsion of 
English surgeons consists in twisting the blood vessels until they 
are torn apart. The effects are similar to those of the ligature, the 
external coat forming a kind of cap which coVers the clot formed, 
and fixes it firmly. Ligature is surer than torsion; in arterioles of 
some caliber, the cellular coat may untwist and a secondary hemor- 
thage follow. 
The /forcipressure has distanced all other hemostatic processes. It 
consists in applying, upon the ends of the divided blood vessels, 
fixed forceps, which are left for a variable length of time, either 
until the blood vessel is closed by a clot, or only until the end of 
the operation, when permanent hemostasis will be realized by the 
ligature. ‘ 
Recommended by Keeberlé and Péan, multiple forcipressure is 
now used everywhere, as a means of temporary or permanent 
hemoStasis. Among excellent forceps recommended, those of Collin 
