ANEURISMS, 355 
‘of Valsalva) is now left aside. Digital or elastic pressure (method of 
Reid) is not practicable in veterinary surgery on account of the restless- 
ness of our patients. Coagulating agents, so much in favor in days gone 
by, are now ignored. Ligature and extirpation are now the only modes of 
treatment resorted to by surgeons, 
Ligature may be applied above or below the sac, or on both at once; 
the operation is simple. Aseptic catgut or silk is used. The ligature 
above the sac (method of Anel-Hunter) has many advocates. As soon as 
it is made, the tumor flags. down, the murmur, pulsation, and expansive 
movements cease; the region becomes cold. The circulation through 
the collaterals is generally sufficient to prevent the gangrene of the re- 
gion where the ligated vessel carried the blood ; still there is a possibility 
of this dangerous complication. A clot closes the sac. Under the in- 
fluence of the collateral circulation, the blood reappears in the tissues, in 
the sac itself, and the passive clot is transformed into anactive clot. The 
recovery thus requires : “ (1) the temporary arrest of the circulation and the 
formation of passive clots; (2) the graded return of the circulation, allow- 
ing the transformation of the passive fibrino-globular clots into active, 
‘fibrinous.” (Michaux.) 
Double ligature, above or below the dilatation, is used as much as the’ 
preceding. In the horse, La Motte has cured with it an aneurism as 
big as a chicken’s egg, situated on the poll, behind the ear, and developed 
on the posterior cervical artery. In a similar case, Peters has also been 
successful with the same treatment. 
Extirpation of the sac. between two ligatures is considered by some - 
surgeons (Trélat, Delbet) as the choice mode of operation. It is more 
complicated and requires more division of tissues than ligature, but it is 
radical in its effects; it removes the possibility of return and does not 
expose to the suppuration of the sac. 
One may be called to treat a hemorrhage due to the opening of an 
aenurism. Reimers had a similar accident in a steer which had a tumor 
on the croup; the bleeding was stopped by plugging and perchloride of 
iron. In some cases, interference must be applied as quick as possible. 
_ Plugging, iodoformed gauze, double ligature or extirpation are indicated. 
ARTERIO-VENOUS ANEURISMS. 
In these, there is an accidental or spontaneous communication between 
an artery and a vein. Traumatisms are generally the cause. It has 
occurred in man quite often by bleeding with the lancet. The arterial 
blood, with its pulsating force, enters into the vein and distends it. A soft 
tumor is formed, whose characteristic symptom is the vibrating trem- 
