On spontaneous gangrene from arteritis and the causes of coagulation of the blood in diseases of the blood-vessels / by Joseph Lister.

  • Lister, Joseph, Baron, 1827-1912.
Date:
[1858]
Catalogue details

Licence: Public Domain Mark

Credit: On spontaneous gangrene from arteritis and the causes of coagulation of the blood in diseases of the blood-vessels / by Joseph Lister. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    affected, I resolved to destroy the vitality of a vein, and then permit the blood to flow through it for some time, and ascertain whether coagulation would occur in spite of the current, as it must do in phlebitis.^ The agent which seemed best adapted for inflicting the lesion was strongest liquor ammonias, both on account of its rapid action, and also from the circumstance that, as Dr Richardson has shown, its chemical effect upon the blood, whether applied concen- trated or diluted, is to prevent coagulation. On the 8th inst., having exposed one of the jugular veins of a sheep, and isolated it from suri'ounding conjiections for six inches of its length, carefully avoiding even momentary obstruction of the flow through it, I placed a plate of glass beneath the vein, to protect the neighbouring tissues from the action of the alkali, and at 3 13 P.M., emptied the portion of vein of its blood, by stroking the finger along it, while an assistant exerted gentle pressure on the anterior part, and then at once applied the liquor ammonise thoroughly, with a camel's hair brush, to all sides of the vessel throughout the length exposed. The application of ammonia occupied three quarters of a minute, and three quarters of a minute later the blood was again allowed to flow through the vessel, having been arrested altogether a minute and three quarters. A. short time having been allowed for the evapora- tion of the ammonia, the edges of the wound were brought together with stitches. At 4,58, or an hour and three quarters later, the wound having been opened, the flow was again obstructed as before, and the vein was rapidly slit up. A small amount of dark coagulum escaped with the fluid blood. The interior of the vessel was now immediately examined. A valve with three flaps, about the middle of the opened portion, was rendered conspicuous fi-om the fact that a black coagulum existed between each of the flaps and the wall of the vessel; and on careful observation of the lining membrane of the vein in other parts, it was seen to be dotted over in patches with fine granular deposits of pink fibrine, which could only be. detached by firmly scraping with the edge of the knife, reminding me pre- cisely of the close adhesion of the clot which occurred in the pop- liteal artery in the case which I related at the commencement of tin's, paper, and which is known to be characteristic both of arteritis and phlebitis. Here it is clear that the coats of the vessel having been deprived of their vitality, the blood flowing through it assumed the same chemical tendencies as we have seen it to possess when removed from the body; and those parts of the fluid which re- ^ Sir Astley Cooper performed experiments to show the effect of mechanical injury of the coats of a vein upon the coap^ulation of the blood at rest within a portion of the vessel contained between two ligatures ; and he came to the general conclusion, that loss of vitality in the vessel greatly accelerated the pro- cess of coa^rulation. ])t Richardson alludes to these experiments, but says they have been invalidated by subsequent investigations by Scudamore. 1 have not as yet seen Sir Astley's own account of his researches on this subject ; but, from a notice of them by Palmer, in his edition of Hunter's works, I suspect that they Ho not deserve to be set aside so lightly.