Page:Popular Science Monthly Volume 22.djvu/638

620 ceased, who would have dared to suggest that the entire limb of a living man should be deprived of its blood during the time occupied by a tedious operation?

Then, with regard to the means of permanently arresting the escape of blood from the wounded vessels. We have no longer a receptacle for blood; indeed, the handful of sawdust on the floor that was fashionable when I began medicine is no longer used. John Bell, after giving a graphic and fearful account of the terrors of haemorrhage, says: "Is not this fear of hæmorrhagy always uppermost in the mind of the young surgeon? Were this one danger removed, would he not go forward in his profession almost without fear?" I do not think this fear ever crosses the mind of the young surgeon now, so rare are deaths from external hæmorrhage. I have never seen one death from such loss of blood in the twenty years that have passed since I first commenced to study medicine. Why has the dread of bleeding ceased to chill the heart of the surgeon when entering on an operation? Vivisection has not done all, but it has done much to help us to attain to this degree of excellence in our present methods.

The use of the ligature can be traced so far back in the history of medicine that it is impossible to say whether it was first used upon man or animals. Very definite accounts of it occur in the writings of the Arabians of the tenth or twelfth century. Although its value, or rather its great convenience, in military surgery was recognized and extolled by Ambroise Paré, the inestimable value of the ligature remained unknown in general practice for nearly a hundred years after his time. This was, no doubt, partly on account of the fact that experiment was not used to test its efficacy and mode of action until comparatively recently. By vivisections the chief errors in its application were by slow degrees removed, and now we rest almost exclusively on the improved method of tying arteries as the means of arresting the flow of blood from a recent wound. First of all, the nerves used to be included in the ligature. Vivisection showed the folly of thus attempting to confine the animal spirits, or nervous fluid, and practice proved that thus tying the nerves always caused excruciating agony, and often gave rise to fatal spasms (tetanus), which made ligature to be dreaded even by its warmest advocates. In the second place, the wide ligatures which were made of soft material and lightly tied over corks, etc., often failed to check the bleeding. Dr. John Thomson, of Edinburgh, was among the first who made experiments on this subject, and I believe much of the credit given to Jones really belongs to him. Following the precepts taught by Thomson, Jones also made numerous experiments on animals. He found that a hard, thin ligature, applied so as to cut the elastic inner coats and leave the tough outer wall of the vessel uninjured, was much more surely followed by a deposit of "coagulable lymph," and by more satisfactory occlusion of the vessel, than when one or several