To illustrate this opinion, his work on the ligature may be taken. It
had long been the universal practice of surgeons to employ threads of
silk or flax for tying arteries, long ends being left to provide escape
of the pus (invariably formed during the tedious process of the
separation of the ligature) together with the portion of the arterial
coats included in the knot. Lister hoped that if, by antiseptic means,
the thread were deprived of living microbes, it would no longer cause
suppuration, but might be left with short cut ends to become embedded
permanently among the tissues of the wound, which thus would be allowed
to heal by primary union throughout. A trial of this method upon the
carotid artery of a horse having proved perfectly successful, he applied
it in a case of aneurysm in the human subject; and here again the
immediate results were all that could be desired. But a year later, the
patient having died from other causes, the necropsy showed remnants of
the silk thread incompletely absorbed, with appearances around them
which seemed to indicate that they had been acting as causes of
disturbance. Thus was suggested to him the idea of employing for the
ligature some material susceptible of more speedy absorption; and the
antiseptic treatment of contused wounds having shown that dead tissue,
if protected from putrefaction, is removed by the surrounding structures
without the intervention of suppuration, he resolved to try a thread of
some such nature. Catgut, which is prepared from one of the constituents
of the small intestine of the sheep, after steeping in a solution of
carbolic acid, was used in a preliminary trial upon the carotid artery
of a calf. The animal was killed a month later, when, on dissection, a
very beautiful result was disclosed. The catgut, though removed, had not
been simply absorbed; pari passu with its gradual removal, fibrous
tissue of new formation had been laid down, so that in place of the dead
catgut was seen a living ligature embracing the artery and incorporated
with it. The wound meanwhile had healed without a trace of suppuration.
This success appeared to justify the use of the catgut ligature in the
human subject, and for a while the results were entirely satisfactory.
But though this was the case with the old samples of catgut first
employed, which, as Lister was afterwards led to believe, had been
"seasoned" by long keeping, it was found that when catgut was used fresh
as it comes from the makers, it was unsuited in various ways for
surgical purposes. The attempt by special preparation to obtain an
article in all respects trustworthy engaged his attention from time to
time for years afterwards. To quote the words of Sir Hector Cameron, who
was for several years assistant to Lord Lister, it required "labour and
toilsome investigation and experiment of which few can have any adequate
idea."
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account