196 Treatment of Vascular Diseases. 



course of the artery, especially proximid, and upon the tu- 

 mour itself, the patient remaining in the horizontal position, 

 with the member kept stationary by means of splints or the 

 like. His diet should be easily digested, and nourishing, 

 while he abstains from all heating substances. To these 

 means may be added the exhibition of digitalies, &c. so as to 

 retard the circulation. When these remedies have not had 

 the desired effect, blisters over the aneurismal tumour, or any 

 other stimulus, will be found of use by increasing the irrita- 

 tion, and thus augmenting the tendency of the blood to con- 

 solidate in the diseased part. The following are examples 

 of the usual course of favourable cases of aneurism, as cured 

 by the operation now performed, aided by the effect of local 

 irritation. They were published by Mr. Porter, the dexter- 

 ous Dublin Surgeon. 



Case 6th. — Edward Hopkins, aged 63, of a weak and sickly 

 constitution, was admitted into Hospital with an axillary 

 aneurism. It produced the usual distressing symptoms, and 

 amidst many difficulties, the artery was tied with a ligature 

 on the inner border of the scalenus muscle. The operation 

 lasted 25 minutes, and a smart attack of fever followed its 

 performance. The circulation in the smaller vessels of the 

 arm was soon restored, and the patient complained of weak- 

 ness and oppression about the heart, accompanied with such a 

 train of symptoms, that for some time he was considered in 

 the greatest danger. The wound however continued to go on 

 favourably ; the ligature came away on the morning of the 1 7th 

 day after the operation, without a drop of blood ; and the 

 aneurism had diminished in size. On the 31st day after the 

 operation, the aneurismal tumour had diminished nearly one- 

 half in size, and the coagulum (consolidated blood) could be 

 felt firm and defined. No pulse, nor even a thrill was percep- 

 tible in any artery in the limb beyond the aneurism, from 

 the weakness of the individual's constitution. Had the 

 tumour been larger, it is probable that supuration would have 



