with surgery, and particularly with aneurism, which he has so fully investigated. It is probable that if he and some others of the supporters of this practice, have exaggerated its advantages in England: on the contrary, we have been too hasty in forming an unfavourable judgment on the subject, our experience being still so limited, and the facts on either side of the question so few.

We therefore feel gratified in being enabled to lay before our readers, from Omodei's Annali, the history of three cases in which this mode of practice was adopted. The first of these is related by Giuntini, Professor of Surgery in the Great Hospital of Florence.* A young woman, aged 22, and of a delicate habit, was wounded August 7th, 1820, in the upper and inner part of the fore-arm. The great loss of blood, and the seat of the injury indicated a wound of the ulnar artery. The surgeon who was called, removed a bandage which had been applied in the first instance, and the wound united by the first intention. On the ninth day the hemorrhage reappeared, and was restrained by the tourniquet and by compression on the wound. In this state the patient was carried to the hospital, August 22d. "I removed the tourniquet," says Giuntini," and exposed the wound, which did not bleed. Every thing proceeded well, until the morning of the 26th, when a pulsating tumour was discocovered in the lower angle of the wound, in the direction of the ulna. This circumstance determined me on exposing and tying the ulnar artery, which however proved to be impracticable, from the suppuration of the wound, the quantity of coagula, the flow of blood, and the depth at which the artery lay. I therefore resolved on tying the trunk of the brachial artery above the bend of the elbow, according to the method of Professor Scarpa, that is by employing a single ligature, and interposing a cylinder of linen, spread with cerate, between the ligature and the artery, for the purpose of preserving the middle and inner coats of the vessel from rupture. Shortly after the operation a slight pulsation was felt in the radial artery, and in its dorsal and palmar branches.

At the end of the third day from the operation, by the aid of the nail of the index finger of the left hand, I introduced a small convex-edged knife to the bottom of the wound, and cautiously divided the ligature on the cylinder of linen, and removed the whole with great facility, as I had taken the precaution of attaching the cylinder to a thread. This being done,

* Omodei, Annali Universali Medicina, 1821.

I brought the edges of the wound together with strips of adhesive plaster. On the morning of the sixth day after the operation, I found the upper wound healthy, and the lower in full suppuration. The pulsations of the radial artery became daily more manifest, and the remainder of the cure proceeded regularly.

In the second CASE by Uccelli, Professor of Surgery, in the Great Hospital of Florence, the femoral artery of a man, aged 37, was tied in the usual place for the cure of a popliteal aneurism. The operation was performed with a waxed ligature of several threads, a cylinder of linen being interposed between the ligature and the artery. In addition, for the purpose of facilitating the removal of the ligature, a small director, grooved and curved at the point, was placed between the cylinder and the ligature. On the fourth day from the operation, a pair of scissors was carried to the bottom of the wound, in the groove of the director, and the ligature was divided and removed together with the cylinder. The edges of the wound were then brought together with adhesive plaster. The pulsation in the aneurismal sac ceased, and the tumour gradually diminished in size from the day of the operation. About the twentieth day serious constitutional symptoms took place, though apparently independent of the operation. Notwithstanding this the femoral artery remained at the point where it was tied, quite impervious to the current of blood.

The third CASE is related by Menegazzi, Physician and Surgeon to the Hospital of Lendinara. Bellin Panfilio, aged 44, a fisherman, of the Commune St. Urban, Padua, had for three years suffered successive injuries in the lower extremities. At the end of that time he perceived a small indolent tumour on the left ham, which he neglected, but as it increased in size, it became inconvenient, rendered motion difficult, and induced a degree of numbness in the leg, which confined him to his bed, in which he had been four months when I saw him. The pulsation in the tumour was manifest, but was removed by compression of the femoral artery, which also reduced its size. it was about as large as a turkey's egg, prominent in the middle, and the integuments covering it so thin as to threaten rupture. This determined me on hastening the operation, in spite of his bad state of health, aggravated by poverty, confinement, and constant suffering. Having removed the patient to the hospital, and premised some gentle purgatives, I proceeded to this operation on the morning of the 3d of January, 1820.

The femoral artery being exposed by an incision in the upper part of the thigh, I detached it to a sufficient extent to

allow the passage of a needle with a ligature, I then placed on it a roll of linen spread with cerate, and drew the ligature so tight, as to stop the pulsation in the tumour: I then brought the wound together with adhesive plaster. The patient experienced but little pain from the operation, and I placed bladders filled with warm water on the limb, and left him to repose.

On the fourth, he complained of dryness and bitterness of the mouth, with thirst and pain over the eyes. His bowels was moved by castor oil: He felt no pain in the knee or leg, but did not sleep at night. On the fifth, as the same symptoms continued, I ordered a decoction of tamarinds. On the morning of the sixth, I removed the dressings; I found the wound partly closed by adhesion, and open only at the point corresponding to the ligature, which I readily removed, together with the cylinder, closing the wound with adhesive plaster. The symptoms increased, being accompanied with fever, head-ache, bitterness of the mouth, &c. I ordered an emetic-cathartic draught. The suppuration was copious and extended in the course of the femoral artery. On the twelfth it was necessary to open a small abscess, which had formed near the groin. On the following days the flow of matter was less copious: the state of the patient was improved. The size of the tumour had diminished by one-half, and the limb could be moved without difficulty. On the eighteenth M. Menagazzi was compelled by the state of his health, to abandon his patient to another surgeon, and did not see him again until the 16th February, when he found him almost expiring. He discovered the cause of this to be the suppuration of the aneurismal tumour, and the diffusion of matter through the whole leg, with fever, delirium, and emaciation. He opened the tumour and evacuated a large quantity of matter, but without relieving the patient, who died on the following day. The wound of the operation was closed, and the thigh was in a natural state.

On DISSECTION the injection of colored wax by the abdominal aorta, shewed that the parietes of the artery had adhered at the point of ligature, and that the vessel was impervious from this point to its division into the superficialis and profunda of the thigh. The parietes of the external iliac were much thickened, and firmly connected to the surrounding parts. Beyond the femoral arch, the parietes of the vessel were still more thickened and confused with the parts in the vicinity. The coats of the profunda were in a healthy state. Below the point of ligature the internal surface of the artery was not adherent, and still lower down, it contained some purulent matter, similar to that found in the tumour. The cellular tunic enclosing the aneurismal

sac was ulcerated and disorganized. The bones in the neighbourhood were in a state of caries.

In addition to these important observations, the Editor of the Annali Universali says, that he knows on good authority, that the surgical clinic of Prague has presented some remarkable examples of the utility of the temporary ligature, and that the history of these observations is likely to be soon laid before the public.

Our limits do not permit us to follow Dr. Omodei, through the whole train of reasoning which he has employed to invalidate the inferences which may be drawn against the employment of the temporary ligature from the first case of Mr. Travers. The point on which he seems principally to insist, is, that in this instance the ligature was withdrawn from the artery, after a period of time, (twenty-seven hours,) too short to have effectually secured the union of the coats of the vessel; and that for the estimate of the length of time necessary for this process, we should refer, not so much to experiments performed upon brutes, as to what is daily observed in the human race, with regard to the cause of simple wounds by the first intention, which is rarely compleated before the third day. It is from the identity of the adhesion of wounds, with the coalition of the coats of a tied artery, that Scarpa has laid down the general principle, "that the ligature should not be removed from the large arteries in the human subject before the expiration of the third day." Mr. Travers has also been led into error when he supposes that Scarpa employs two ligatures over the roll of linen. He has long employed but a single one, composed of several threads, applied with the least possible detachment of the artery. We are likewise informed in the Dict. des Sciences Medicales, Vol. 28, that M. M. Boyer and Roux continue to operate for popliteal aneurism after the method of Scarpa, and that they ordinarily remove the ligatures in three or four days.

There is a circumstance in Mr. Travers's case, which seems to us to deserve consideration. If the temporary ligature was inadequate to restrain the circulation through the artery, how comes it that no secondary hemorrhage took place, or that no aneurismal tumour formed at the point of ligature (the inner coats of the vessel being necessarily cut)? Have we not an equal right, in the absence of positive information, to suppose that the pulsation in the tumour returned, from the establishment of a collateral circulation, which as we know occasionally takes place? We are aware that this is but conjecture, but we do not think that it is contradicted by any other circumstances in the case, not even by the effects which followed the application of the second ligature,

PREVOST AND DUMAS' EXPERIMENTS ON THE RED GLOBULES AND TRANSMUTATION OF THE BLOOD.

THESE Gentlemen, passing over the other constituents of the blood, have directed their observations chiefly to its red globules. They have examined these with a microscope in the foot of a frog and in the wing of a bat, and also in blood drawn from the body. In the former cases the globules have presented to them, sometimes a flat surface, sometimes their edge-at others balancing themselves in the liquid in which they are suspended, they have afforded a view of their forms, more or less oblique. From repeated and careful observations of this kind, Messrs. Prevost and Dumas have adopted the opinion of Hewson, that these globules are flat, and furnished with a point swelling out in the centre. They do not therefore admit the opinion of Sir Everard Home, that they are in any case strictly globular bodies.

With regard to the shape of these red particles, they coincide with Hewson, who found them to be circular in the mammalia, and oval in birds and in cold blooded animals. They have measured their diameter in the frog and bat, by means of a micrometer; and have also determined their size, after they were withdrawn from the vessels. This was done by rapidly drying small drops of blood upon a plate of glass, by which means the globules retained their proper figures-they then brought the object seen through the microscope by the right eye, to coincide with a graduated scale perceived by the left and often they chose a line of globules, and by determining its length, and the number of globules, found easily the diameter of each. They have not found any change take place in the size of the globules, after their leaving the blood vessels, provided they took proper care to have the drop of blood quickly dried.

eye;

In a table of the diameters of these red particles in various animals, we find those of man, of the dog, of the rabbit, pig, Guinea-pig, and hedge-hog, to be alike, 1-150 millimetre, or 1-3100 of an inch. Of the ass to be 1-167 millimetre, or 1-4200 of an inch; of the cat, and mouse, 1-171 millimetre, or 1-4300 of an inch; of the sheep, horse, mule, cow, 1-200 millimetre, or 1-500 of an inch; of the goat, 1-288 millimetre, 1-700 of an inch. Globules of similar form and dimensions were found in the milk, pus, and chyle of various animals. In all their trials those red globules of the blood readily formed