In the treatment of aneurisms exterior to the great cavities, important improvements have been made in modern times. No success can be expected to follow palliative and temporizing measures, and a cure can result only from operation. Formerly it was the practice to lay open the aneurismal tumour, to search for the extremities of the artery opening into the cavity, and to secure them by a ligature, or close them by pressure, styptics, or both. In some few instances this method had permanent success; but in the majority the operation proved wholly abortive, and not unfrequently fatal. It was necessarily tedious in its performance, and attended with much danger, the blood being discharged in great profusion immediately after the opening of the sac, and the extremities of the vessels being with great difficulty detected and secured. Besides, the vessels in the immediate neighbourhood of the tumour having generally undergone the degeneration already mentioned, were incapable of taking on any healthy action; the application of ligature on a vessel thus circumstanced could consequently be productive of no advantage. From this method having almost invariably proved unsuccessful, practitioners in those days generally preferred amputation, when the tumour was so situated as to allow it; and when the disease occupied a situation in the limb so high as to prevent amputation, the case was deemed incurable, and the patient abandoned to his fate. But amputation was accompanied with circumstances almost equally alarming with those attendant on division of the sac: the hemorrhage was very great; for as a consequence of obstruction to the free passage of the blood in the aneurismal vessel, the circulation was chiefly carried on by the collateral anastomosing branches, which were thereby so much enlarged, as, on their division, to pour out blood with a profusion resembling that of arteries of the second or third magnitude. Continued pressure was employed as a less hazardous method of cure, but was equally inefficacious; and was also attended with danger, from the risk of sloughing. If the practice ever proved successful, it was only after a tedious perseverance in its use, and long confinement of the patient.