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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    inflammation. That^ if these coats are not lacerated it is probable that no lymph ivill unite their opposed surfaces.— The naked-eye and microscopic preparations of the vessels in our experiments, however, show an eSusion of lymph which is ample for the purpose in view, viz. the occlusion of the vessel, so that the plastic exudation cannot be said to be dependent in quality, though possibly in quantity, upon rupture of the tunics. 9. A.—That when two endothelial surfaces are brought into contact they unite with difficultyy and that therefore it is necessary to interrupt the continuity of the tunics. B.—That it is an advantage to bring, by means of the cutting ligature, the adventitia of one side into close relation with that of the opposite side, because union between areolar structu,res is rapidly effected. Our preparations clearly demonstrate that these are theoretical issues having no foundation, and that union is obtained as firmly and as rapidly, and more safely, when the tunics are undamaged than when they are divided. Other endothelial surfaces when in contact are known to adhere on the least provocation. Ziegler' says that a blood-vessel has an anatomical analogy to the serous cavities and that the process by which a thrombus is organised resembles most closely the plastic inflam- mation of a serous membrane. The presence of a ligature even when loosely applied round an artery is suflficient to cause a slight deviation from the normal nutrition of the part, accompanied by plastic effusion, proliferation of the endothelium, and coagulation of the blood. Ziegler figures an organising thrombus fi'om the femoral artery of an old man. The tunics had been ruptured and the examination was made three weeks after ligature. Let this picture be compared with the process as seen in a sheep's carotid twenty-one days after operation without division of the coats. In the latter case the process of organisation is much more advanced than in the former, ' Holmes's ' System of Surgery,' 3rd edit., vol. iii, p. 101. ' Loc. cit., p. 11.