ART. I.-On the use of Animal Ligatures. By W. T. WRAGG, M.D. THE use of ligatures, as they are now applied to wounded arteries for the purpose of arresting hemorrhage, is one of the great conquests of science. When anatomy was imperfectly known, surgery was rudely performed; and it is not very easy to repress a smile, at this day, when we read the directions given by some of our predecessors of the old time, for the performance of certain operations.* Boiling oils and red hot knives were among the means resorted to for the suppression of hemorrhage: and so great was the fear of this accident with some, that, distrustful even of these potent aids, they banished cutting instruments altogether, and, even for amputations, relied upon the tedious process of ulceration, which they effected by ligatures drawn tightly around the part to be removed. But if we are tempted to smile at these rude efforts for remedying or preventing an evil of so fearful a nature-one so well calculated to strike terror into the breasts of the boldest and coolest men, so long as they possessed no better means for effecting an object of such infinite importance-what ought to be our admiration of these very men, when we reflect upon the miraculous achievements in surgical operations performed by them in the face of so great a danger, and with lights, in anatomy and physiology, which, compared with those we now possess, can hardly be considered as more than positive darkness? Let any one run * Mott's Velpeau, vol. ii., p. 440, and others. VOL. II.NO. V. O b Ch22 A765 Ch 22 over a list* of the operations performed by the Greek, Latin and Arabian surgeons-of those which, though belonging to far later times, are yet the inventions of men who, having lived before the Harveyan discovery, were still ignorant of the principles (simple enough to us) upon which hemorrhages can be stopped or prevented, and he cannot withhold astonishment and admiration for their boldness, their skilfulness and success. It is a ground of fair, legitimate pride, to the votaries of our profession, that in every age the wise and skilful have been ready to stake every thing-reputation, emolument and even life upon the hazards of a fearful operation, undertaken for the alleviation of human suffering, or for the preservation of human life. In our own era, the progress of every branch of our science has been such that the expression of an honest pride may be indulged in when we speak of these things. In the treatment of hemorrhagest and the diseases of the arterial system as much has been done, perhaps, as in any other division of our science. That which constituted the grand, the sometimes insurmountable obstacle in the way of great operations, does not cause the surgeon to pause even for a moment. Hemorrhage is now so easily mastered by the ligature, that it hardly ever enters into the appreciation of the propriety of an amputation; and even in other operations, where it is not so easy to get at the cut extremity of an artery, the surgeon who is ready in resources will seldom fail to find means so well adapted for warding off the danger, as to leave him comparatively at ease on this point. Even the uneducated-even the common laborers of our country, have a certain degree of skill, founded on the plain and efficient principles which have been deduced from the grand Harveyan discovery, sufficient to guide them in regard to the first measures to be taken for arresting hemorrhage in cases of accident from cutting or puncturing instruments, and a bandage drawn tightly around the part wounded, between the wound and the heart, so effectually answers the temporary purpose that time is allowed for the arrival of a surgeon, and many lives are thus preserved, which would inevitably have been lost without this timely, though rude assistance. The perfect sufficiency of the ligature for arresting hemorrhage, has had its influence upon the practice of surgery, to an extent far beyond any other single improvement, which ancient or modern times can furnish. Not even the invention of the tourniquet by Morel, and its subsequent improvement, by J. L. Petit, and afterwards by others, some of whom were of our own * Velpeau passim. Cooper's Surg. Dic., Art. Surgery. + See Scarpa, Jones, Physic, Velpeau, Mott, Manec, Græfe, &c. |