A N ±. 



die adhefive inflammation by which it was to be clofed ; 

 and the patient frequently either loft his life by hemorrhage, 

 or was refcued by the performance of amputation under the 

 worft and moft difadvantageous circumftances. The genius of 

 a Hunter was foon ftrnck with the dcfefts of the former 

 plan of operating, and inftead of meddling with the tumour 

 itfelf, and tying the artery in a place where it was in a morbid 

 condition, this diitinguifhed furgcon conceived that it would 

 be far better practice to tie the veflel where it was more 

 likely to be found, viz. at a point fome way from the difeafe 

 towards the heart. Thus in the popliteal aneurifm, he 

 avoided the painful operation of laying open the fwelling in 

 the ham, and more fl<ilfully and fcicntifically took up the 

 femoral artery itfelf in the middle of the thigh. From this 

 important innovation, all the fuccefs which has charac- 

 terized this department of modern furgery has unquef- 

 tionably been derived. By extending the fame principles to 

 other cafes of aneurifm, and putting due confidence in the 

 competency of the collateral and anaitomofing vefTels to 

 carry on the circulation, fome of our prefent furgeons have 

 devifed and pradtifed operations for the cure of fuch aneu- 

 rifms, as a few years ago would have been abandoned as 

 hopelefs and inevitably fatal. Not only have the carotid, 

 the external iliac, and the fubclavian arteries been repeatedly 

 tied with the moft fuccefsful refult, the internal iliac itfelf, 

 whofe fituation feems to render it almoft inaccefiible to the 

 inftruments of the moft (kilful operator, has now had a liga- 

 ture put round it in two memorable examples, one of which 

 we have already noticed in the article Surgery. The other 

 operation was performed by Mr. Atkinfon, of York ; the 

 cafe being a gluteal aneurifm, the fame kind of difeafe for 

 which Mr. Stevens operated at Santa Cruz. The patient, 

 whofe name was Thomas Coft, aged twenty-nine, prefented 

 himfelf at the York county hofpital, April 29, 1817. He 

 was a tall, ftrong, attivc bargeman, not corpulent, but very 

 mufcular. He was enduring great pain from a large, 

 renitent, pulfating tumour, fituatcd under the glutjeus of the 

 right fide, an obvious aneurifm. It had exifted about nine 

 months, and was the confequence of a blow from a ftone. 

 In a confnltation with Dr. Lanfoii and Dr. Wake, the 

 neccflity of the operation was determined upon, and it was 

 performed on the 12th of May, without any material diffi- 

 culty or interruption, except what depended on the aneu- 

 rifm-needle not being pliable enough, and what was the con- 

 fequence of the divifion of, and bleeding from, the fmall 

 mufcular arteries. Having got command of the internal 

 iliac artery within the pelvis, which, fays Mr. Atkinfon, 

 required the complete length of the fingers to accomplifh, 

 the veflel was tied. Sufficient proof of its being the identi- 

 cal artery was repeatedly obtained, by the prefTure upon it 

 flopping the pulfation in the tumour. Dr. Wake, Mr. 

 Ward, and all the pupils, were quite aifured of the circum- 

 ftance. The artery being then tied, the pulfation of the 

 fwelling entirely ceafed. The patient went on tolerably 

 well for fome time after the operation ; the pulfe never 

 exceeded 130, and, after a time, funk to 85 or 90. He 

 became exhaufted, however, partly by the difcharge, and 

 partly by hemorrhage, and died on the 3 1 ft of May, about 

 nineteen days after the operation. It is to be regretted, 

 that fome eitential particulars are omitted in the narration of 

 the cafe, efpecially thofe refpefting the exaft parts divided 

 in the operation, and the place of the external incifion ; yet, 

 on the whole, whoever reads the account can, we think, 

 entertain no doubt about the important faft, viz. that the 

 internal iliac was aftually tied. See the Med. and Phyf. 

 Journ. vol. xxxviii. p. 267. 



Although this operation did not fucceed like that exe- 



A N G 



cuted by Mr. Stevens, the record of it is highly interefting, 

 as tending to difpel the doubts which have been entertained 

 about the prafticable nature of tl e proceeding. Even the 

 aorta itfelf has now been tied in the human fubjeft. Of 

 courfc, the circumilances which juftified fuch a bold pro- 

 ceeding were defperate in the extreme, nor could much 

 hope of the patient's life be indulged ; yet, as it was the 

 only thing from which a poffibility of prefervation could be 

 derived, we think, notwithttandnig its failure, much credit is 

 due to the enterprifing furgeon who performed it. We 

 (hall introduce a few particulars of the cafe in another 

 place. See Aorta. 



In the article Aneurism, in the early part of this Cyclo- 

 pedia, will be found fome obfervations tending to make the 

 reader imagine, that this difeafe arifes from fuch a kind of 

 weaknefs as may be fuppofed to arife from the divifion of 

 the outer coat or coats of an artery. We therefore take this 

 opportunity of correfling the ftatement, fince it has been 

 fully proved by the exper vients of Hunter, Home, 

 Scarpa, &c. that aneurifm never originates from this caufe ; 

 and that even ftripping off the external coat of the veffel 

 will not give rife to fuch an effefl. 



With refpeft to tying tlie fubcktvian artery for the cure 

 of axillary aneurifms, we ought to have remarked, that the 

 operation, as performed by making an incifion above the 

 clavicle, has never had a fuccefsful refult in this country ; 

 but, from a communication lately made to the Medical and 

 Chirurgical Society of London, fuch an operation appears 

 to have been recently executed with complete fucccls by 

 Dr. Poft, of New York. We believe this to be the only 

 inftance in which this mode of operating has cured the 

 difeafe, and faved the patient's life. The artery, however, 

 has been fevcral times taken up in this way in London ; 

 once by the late Mr. Ramfden, and again by Mr. Thomas 

 Blizard ; but their patients did not recover. The par- 

 ticulars of Dr. Port's cafe are inferted in the Medico- 

 Chirurgical Tranf. vol. ix. p. 185, &c. 



ANGAR Island, in Geography, an iHand of the Perfian 

 gulf, lomewhat larger than Ormuz, and equally barren. It 

 is now uninhabited, but prefents traces of former population 

 in the ruins of a confiderable town, and many refervoirs for 

 water. It has two wells and a ftream of good water, is 

 covered with pits of fait and metallic ores, and alfo a foft 

 rocky fubftance refembling lava : its hills, which are over- 

 fpread with fhells of oyfters and other fiih, abound in wild 

 goats, rabbits, and partridges. It forms an excellent har- 

 bour, which has been recommended for a fettlement. 



ANGELO Amehigi, &c.1. 7, ;-. Domenichino ; 1. 17, 

 after hfe, add — The maftcr-piece of all his works, viz. the 

 Entombing of Chrift, is now in the Louvre at Paris. 



ANGIOPTERIS, in Botany, from a.yyo<;, a veffel, and 

 ■rrlifi-, a fern, a faulty name, as being compofed of one 

 already eftablifhed. — Hoffm. Comm. Gott. v. 12. 29. 

 Willd. Sp. PI. v. 5. 69. Swartz in Schrad. Journ. for 

 1801. 273. t. 2. f. 4. Syn. Fil. 166. (Clementea ; 

 Cavan. Leccion. 553.) — Clafs and order, Cryptogamia Fi/i- 

 ces ; feft. examuilatie. Nat. Ord. Filices dorjiferie. 



Elf. Ch. Capfules aggregate, in elliptical, crowded, 

 maffes, obovate, of two equal valves, and one cell, without a 

 ring. Involucrum none. 



This is one of thofe curious genera of ferns, which like 

 Dan^a, Gleichenia, and Marattia, (fee thofe arti- 

 cles,) bear their capfules on the back of the leaf, or frond, 

 without either a ring or involucrum. In the prefent in- 

 ftance, indeed, thefe capfules are not of many cells, like 

 thofe of Datiica and Marattia, but as perfeftly fimple as in 

 OsMUNDA already defcribed, or Botkyciuum hereafter to 



be 



