. New elements of operative surgery . as the sole cause of the death of my patient. While theupper part of the wound put on a favorable appearance, and seem-ed healing, mischief was extending below. The separation of theligature on the fourteenth day, spontaneously, Avithout being follow-ed by any hemorrhage for a number of days, and not until ul-ceration had extended, conclusively proves to my mind, that all thepurposes of the ligature were completely answered—that adhesion wasfully effected. Had it not been for the ulcerative inflammation, nodoubt will be entertained, I think, by surgeons, b
. New elements of operative surgery . as the sole cause of the death of my patient. While theupper part of the wound put on a favorable appearance, and seem-ed healing, mischief was extending below. The separation of theligature on the fourteenth day, spontaneously, Avithout being follow-ed by any hemorrhage for a number of days, and not until ul-ceration had extended, conclusively proves to my mind, that all thepurposes of the ligature were completely answered—that adhesion wasfully effected. Had it not been for the ulcerative inflammation, nodoubt will be entertained, I think, by surgeons, but that my patientwould have recovered. From occupation his constilution was in-deed very old, and with an ill-conditioned habit, every thing favor-ed the process of ulceration. The position of the wound may besaid by some to favor this process, but in a sound healthy habit itwould only retard the wound in its. recovery, but would never pro-mote ulceration. The practicability and propriety of the operation appear to me (Plate U.) 0. ?^ appearing rough and irregular from the erosionor the ulcer. -i c A coagulum of blood adhering pretty firm- -jjr the upper part of the innominata, and particu- ^ carotid, and its extremity also seen in the ul- ^ I7 to one side of the innominata. d Contracted and puckered appearance of cer. in the cavity of the A small bougie passed along the common passed through the subclavian, and appearing larly of its internal coat. e Arteria innominata cut open from the aorta-/ Anomalous branch of the , g The aorta. h Left Carotid. i Left subclavian. k The heart Sternum and clavicle turned , m Pleura much Probe introduced into the axillary artery, Exhibits the morbid appearances whichwere found upon dissection. a, a, a View of the ulcer as it extended un-der the clavicle, and towards the trachea. b The upper part of the arteria innomina-ta, about which the ligature had been applied, DR. MOTT ON ANEURISMS. 3
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