Vol.. 8, 1922 
PATHOLOGY: W. S. HALSTED 
181 
these measurements have been made in detail for many different wave- 
lengths and with the very high degree of precision necessary to observe the 
fluctuations of contrast of brightness from time to time. The measure- 
ments extended beyond the visible spectrum both towards the ultra-violet 
and towards the infra-red, and showed a striking change of distribution 
along the sun's diameter, depending on the difference of wave-length. 
10. Solar Theory. — These solar radiation measurements, including 
those of the solar constant which have led to a value of the sun's effective 
temperature, those on the distribution of light over the sun's disk, and 
those on the transmission of the terrestrial atmosphere considered in con- 
junction with the known results of others on the details of the solar spec- 
trum, have led to a theory of the sharp boundary of the sun and other 
things relating thereto which appears more and more to gain acceptance. 
REPLANTATION OF ENTIRE LIMBS WITHOUT SUTURE OF 
VESSELS'" 
By Wii^IvIam S. Halstbd 
Medicai, School, Johns Hopkins Unfvbrsity 
Read before the Academy, April 24, 1922 
The experiments were undertaken with view to determining the amount 
and duration of the swelling which would result from the division of all 
the vessels and lymphatics of a limb, our interest in the subject arising 
from the desire to obtain experimental support of my contention that 
permanent swelling of the arm following operations upon the axilla is 
probably invariably due to infection, an infection often so slight as to" 
escape the observation of the surgeon. It is almost a daily experience 
of active surgeons to see swollen arms as result of radical operations for 
cancer of the breast. The swelling is frequently so great as to cause 
suffering and disability from the weight of the arm, and occasionally 
patients have consented to amputation of the entire limb for the condition 
which surgeons have been powerless to relieve. The ordinary swelling 
is universally attributed to the removal of the axillary lymphatics and 
veins, and some surgeons have advocated operations less thorough, be- 
lieving that their results as regards the swelling of the arm have been better 
when the axilla was less meticulously cleaned. 
Almost from the beginning of our radical operations for cancer of the 
breast I have been impressed with the fact that infection, however slight, 
was likely to be followed by more pronounced swelling of the arm and that 
the largest arms were noted as a rule in cases in which the inflammatory 
reaction and the axillary induration were greatest. We assumed, naturally. 
