114 



Scientific Proceedings (52). 



progressively occluding the lumen of the artery. But in the 

 course of our experiments we had opportunities to make trial in 

 the human subject of partially occluding bands on other arteries 

 (innominate, subclavian, carotid, femoral, popliteal) whose blood 

 streams in some instances it seemed unsafe to cut off suddenly 

 and completely, and found that incomplete occlusion of an 

 artery sufficed to cure the aneurysm, possibly quite as surely as 

 might have been expected of total occlusion. Hence, tentatively, 

 I abandoned the idea of progressive closure of the aorta, deter- 

 mining, instead, to obliterate the lumen of this vessel, in the 

 attempt to cure its aneurysm, to an extent which we had found 

 quite safe in the dog. 



I have applied an aluminum band to the human aorta four 

 times — twice in one subject — and twice with promising results 

 so far as the cure of the aneurysm is concerned. But the experi- 

 mental work on animals had led me to expect that ultimately the 

 metal bands must cut through the artery, because in cases observed 

 for 7 months or less the wall of the aorta had become atrophied to 

 an extreme degree and there was no adhesion between the 

 infolded, attenuated surfaces. That my fears were well founded 

 was proved by an experience in Europe, about 18 months ago. 

 The patient was an aged woman with dilated and badly functioning 

 heart. The large aortic aneurysm was well located for the placing 

 of a band which was applied just below the renal vessels. Within 

 a few days the aneurysm which before operation was distinctly 

 visible from the seats of the operating amphitheater was barely 

 discernible at the bedside, and at the end of six weeks had dis- 

 appeared so completely that the patient was discharged apparently 

 cured. But, walking out of the door of the hospital she was 

 seized with a pain and returned to her bed. The following morn- 

 ing she died from hemorrhage. The aorta had ruptured at the 

 side of the band, but the aneurysm was found to be nearly cured. 



Stimulated by the results in this case to further experimenta- 

 tion it occurred to me to test the behavior of cuffs and spiral 

 strips of the fresh aorta of one dog when wound about the aorta 

 of another. So on the 29th of April, 1912, I operated upon two 

 dogs, partially occluding the aorta of .one of them with a spiral 

 aortic band and of the other with a cuff cut from the same vessel. 



