Treatment of Vascular Diseases. 197 



taken place in the tumour, from the want of vitality in th© 

 blood, and increased still more the danger of the operation in 

 so weak an individual. 



Case 7th. — The second case of Mr. Porters, which I shall 

 mention, is that of Matthew Collins, aged 47, who had an aneu- 

 rism of the subclavian artery, above the clavicle. The liga- 

 ture was attempted to be placed on the innominata ; but such 

 were the difficulties met with, that " after the most painful 

 exertions during an hour and a quarter, the accomplishment 

 of the operation was abandoned. On being put to bed, the 

 patient had a long rigor, followed by fever. Next day he only 

 complained of the wound being a little sore, and the strength 

 of pulsation in the aneurismal tumour appeared to have 

 diminished. The patient was kept perfectly quiet ; digitalis 

 was given three times a day, and ice applied to the tumour. 

 During the second and third day after the operation, the 

 wound had some slight inflammation round it, and a reddish 

 serous discharge proceeded from it. On the fourth day the 

 pulsation in the tumour was not so distinct as before the 

 operation ; on the tenth day the tumour appeared smaller, 

 and was " undoubtedly" harder and firmer. On the 16th 

 day, Mr. Porter supposed the aneurismal tumour was still 

 receiving fluid blood ee for since he arose from bed, and dis- 

 continued the use of digitalis, the pulsation has become 

 just as plain and as forcible as it was before the operation." 

 " The day following," he continues, " the features of this curi- 

 ous case have still undergone another change. The tumour 

 has gradually diminished, and is now not one-quarter the 

 size it was on his admission, and the pulsation is scarcely 

 perceptible. He is recovering both feeling and power in the 

 arm. His health is excellent." 



The explanation of the course of the cure in these cases ap- 

 pears to be sufficient. The cure of the aneurism, from the con- 

 solidation of blood in the cavity, was caused by the irritation 

 produced by the long protracted operation, followed by the 



