The ligation of the larger arteries in their continuity : an experimental inquiry / by Charles A. Ballance and Walter Edmunds.

  • Ballance, Charles Alfred, Sir, 1856-1936.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: The ligation of the larger arteries in their continuity : an experimental inquiry / by Charles A. Ballance and Walter Edmunds. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    artery cohere by multiplication of the opposed endothelial cells without the formation of clot. Of the accuracy of this observation we have grave doubts. Any alteration in the endothelial lining would certainly lead to the formation of a coagulum, and the endothelial multiplication in our specimens is always accompanied by a leucocytic exti'avasation^ the latter apparently being of more import- ance than the former. A long time after ligation the clot disappears and leaves the interior of the vessel—on either side of the ligatured point—in shape something like a hollow cone. This may possibly be the explanation of the statement of Reidel. The time at which the clotting took place in these experiments is a matter of doubt, but it probably super- vened soon after the operations were over. The shortest time which elapsed between ligation and the death of an animal was nine hours. Here the clot was perfectly formed. When the coats are ruptured the clotting com- mences at once on the infolded edges of the cut tunics, but in these arteries no such cause was present and the development of the coagulum must be attributed, not to the stasis of the blood current, but to the change in the vital state of the arterial wall due to the pouring out of lymph at the point of ligature. VIII.—The Ligature. Experiments upon arteries in the post-mortem room show : 1. That the effects produced by the use of a silk or other ligature applied in the ordinary way are not uniform. The middle coat is sometimes only partly cut through but in other instances a mere strand of tissue representing the outer coat alone remains, which remnant is thinnest and quite transparent under the knot of the ligature. Here then is ample reason for the occasional occurrence of