Excerpt from Experimental Researches on Cicatrization in Bloodvessels After Ligature

Hennen adopted the practice in 1813, and within four months followed it in 34 cases without observing any unfavorable results. Delpech and Guthrie also indorsed this practice. The introduc tion of antiseptic surgery has, however, wrought the greatest improvement in the ligature, and the founder of antiseptic sur gery, Sir Joseph Lister, has also furnished us with the ideal ligature - the aseptic ligature. What has been sought for cen turies has at last been found, a ligature which will arrest the circulation with safety and certainty, and a minimum amount of traumatism until the process of cicatrization is completed, and when its work is accomplished it gradually disappears by absorption and substitution.

Since the introduction of the antiseptic treatment of wounds and the aseptic ligature, surgery has received a new impulse, results have been obtained which were never realized before, Operations have been performed successfully which were pre viously beyond the grasp of even the most ambitious, and, more than all, those horrible spectres, hospital gangrene, erysipelas, pyzemia, septicaemia, and secondary hemorrhage, which haunted the surgeons Of only fifteen years ago by night and by day, have almost completely disappeared from hospital as well as private practice. For all this we are indebted to Lister. A variety of other animal tissues have been prepared into ligatures and made aseptic, and have been recommended at different times as substitutes for the catgut ligature. Among them we may enumerate silk, silkwormgut, whale and deer tendon, perito neum, coats of bloodvessels, and nerve tissue. With the excep tion of the first two, all of these ligature materials, if rendered perfectly aseptic, will, after a certain time, undergo absorption, but it is questionable if any of them possess any advantage over well-prepared catgut. Czerny is entitled to a great deal of credit for the improved silk ligature. He has demonstrated that whencomposed of unstriped muscular fibres, elastic tissue, connective tissue, and endothelium. From an anatomical, physiological, and, I may add, pathological, standpoint, it has been customary to distinguish three coats, called respectively, according to their location: 1. Internal or Intima; 2. Middle or Media; 3. Exter nal or Adventitia. In larger arteries these coats can be sepa rated and recognized without the aid of the microscope.

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