THE ORDINARY TIGHT SILK LIGATURE.

Is inevitably expelled to the surface with great danger of attendant secondary hemorrhage.

THE CONSTRICTING SILVER LIGATURE.

Suffers no displacement, becomes completely encysted, as does also the cir cumference of the artery for some distance above and below it, permanently.

WHAT THE AUTHOR CLAIMS TO HAVE ACCOMPLISHED BY THE FOREGOING EXPERIMENTS.

Constricting silver ligatures are shown in situ, which, after nearly fourteen months of quiet residence, are still seen just where they were first placed, with no evidence beyond the closure of the artery of abnormal action in the past, and with no indication of change in the future.

By the experiments I have submitted in this essay, it is established

Firstly, that the "constricting silver ligature" is sufficient to induce permanent closure of an artery.

Secondly, that its use is free from distinctive inflammation.

Thirdly, that the looseness of the ligature as described, is essential to its permanence.

As far as I can ascertain, closure of arteries by this method has never before been accomplished nor suggested.

After careful search I fail to find a recorded instance of ligature in which equal permanence has been demonstrated.

EXPERIMENT I.

Results after ligation of common carotid of sheep, with silver wire fastened by twisting tightly with intent to divide the internal coats. The free ends are cut off closely, and the ligature left behind. Specimen removed 56 days after the operation.

a. Point where ligature was applied.

b, b. Artery above and below solidified.

c, c, c, c. Walls of abscess formed of thickened external coat

of artery.

d. The ligature embracing the internal coats corresponding to the length of the abscess in the middle of which they were found wholly detached.

Fig I.