. The principles and practice of surgery. ncem the ligature, the advocates of other methods must present to ustherefore a much larger and more varied experience than they have yetdone. Theoretically, I should expect accidents from bleeding morefrequently after torsion, acupressure, and crushing, than after ligation ;and from all that I have seen and heard of these methods as practised byother surgeons, I believe that the accidents have actually been muchmore frequent. As to the obstacles which ligatures oppose to primary union, it mustbe remembered also that there are other local and constitut
. The principles and practice of surgery. ncem the ligature, the advocates of other methods must present to ustherefore a much larger and more varied experience than they have yetdone. Theoretically, I should expect accidents from bleeding morefrequently after torsion, acupressure, and crushing, than after ligation ;and from all that I have seen and heard of these methods as practised byother surgeons, I believe that the accidents have actually been muchmore frequent. As to the obstacles which ligatures oppose to primary union, it mustbe remembered also that there are other local and constitutional con-ditions which tend to defeat this end besides a ligature; and that thereare a good many cases in which primary union is not desirable and isnot sought for. Acupressure.—In December, 1859, Sir James Y. Simpson firstdescribed to the Royal Society of Edinburgh, Acupressure, as a newhcemostatio process? His method may be briefly described as follows:—A needle is thrust through the flaps or sides of the wound, and after Fig. Cutaneous Surface of Flap. Wounded Surface of Flap. Fig. 36. being made to cross and compress the mouth of the bleeding vessel, isagain brought to the surface through the integument at an oppositepoint, just in the same way that in fastening a flower to the lapel ofour coat, we cross and compress the stalk of it with the pin. Acupressure, as devised by Sir James Simpson, has been variouslymodified in the hands of different operators, and it is now customary toindicate these modifications by ordinals, as the first, second, etc. The second method consists in inserting a needle, threaded with twisted and annealed iron wire, into thesoft tissues a little to one side of the ves-sel, making it emerge close to the point of the needle is then carriedacross the artery and dropped downagain and thrust into the soft tissues onthe other side of the vessel. The objectof the wire thread is to facilitate the re-moval of the the third met
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