Treatment of Vascular Diseases. 



193 



the time. The external saphena vein had been divided, 

 and two inches of the vessel was separated from the neigh- 

 bouring attachments, hung out of the wound, and drop after 

 drop of blood flowed from its cut extremity. As a more 

 considerable haemorrhage might be expected when the patient 

 had recovered from the faint condition in which he then 

 was, I tied a ligature round the bleeding vessel. Forty-two 

 hours after its application I divided the vein with a pair of 

 scissors (at c), beyond the part to which the ligature had 

 been applied. The cut extremity of 

 the vein, next the limb, formed a 

 round circle filled up with a firm, 

 red, homogeneous portion of consoli- 

 dated blood, as represented in Fig. 

 1. On pressing the vessel between 

 the fingers, close to the divided part, 

 no blood flowed ; as the solid blood 

 adhered to the internal coat of the 

 vessel. On dividing the part of the 

 vein cut off, its extremity from a (Fig. 2) to the liga- 

 ture by appeared of the natural colour, and possessed the 

 usual properties of venous tissue. The vessel from b to c 

 produced by the ligature was filled with consolidated blood, 

 which was tough, and adhered intimately to the internal 

 tissue of the vessel ; the coats of which were denser and 

 thicker, and the neighbouring parts appeared more vascular 

 than natural. 



In this case the ligature caused the irritation, which pro- 

 duced the consolidation of blood, and its adhesion to the 

 thickened coats of the vessel. This constitutes the ad- 

 hesive inflammation ; and not the effusion of coagulable 

 lymph, and the adhesion of the opposite sides of the ves- 

 sels, as analogy has led pathologists to suppose. It is a 

 like consolidation of blood, in the cells of the erectile tissues, 

 that first stops the circulation, and prevents dangerous con- 



2 c 



